ENLIGHT: European network for Light ion hadron therapy.

Science.gov (United States)

Dosanjh, Manjit; Amaldi, Ugo; Mayer, Ramona; Poetter, Richard

2018-04-03

The European Network for Light Ion Hadron Therapy (ENLIGHT) was established in 2002 following various European particle therapy network initiatives during the 1980s and 1990s (e.g. EORTC task group, EULIMA/PIMMS accelerator design). ENLIGHT started its work on major topics related to hadron therapy (HT), such as patient selection, clinical trials, technology, radiobiology, imaging and health economics. It was initiated through CERN and ESTRO and dealt with various disciplines such as (medical) physics and engineering, radiation biology and radiation oncology. ENLIGHT was funded until 2005 through the EC FP5 programme. A regular annual meeting structure was started in 2002 and continues until today bringing together the various disciplines and projects and institutions in the field of HT at different European places for regular exchange of information on best practices and research and development. Starting in 2006 ENLIGHT coordination was continued through CERN in collaboration with ESTRO and other partners involved in HT. Major projects within the EC FP7 programme (2008-2014) were launched for R&D and transnational access (ULICE, ENVISION) and education and training networks (Marie Curie ITNs: PARTNER, ENTERVISION). These projects were instrumental for the strengthening of the field of hadron therapy. With the start of 4 European carbon ion and proton centres and the upcoming numerous European proton therapy centres, the future scope of ENLIGHT will focus on strengthening current and developing European particle therapy research, multidisciplinary education and training and general R&D in technology and biology with annual meetings and a continuously strong CERN support. Collaboration with the European Particle Therapy Network (EPTN) and other similar networks will be pursued. Copyright © 2018 CERN. Published by Elsevier B.V. All rights reserved.

Factors Associated with Unplanned Dialysis Starts in Patients followed by Nephrologists: A Retropective Cohort Study.

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Pierre Antoine Brown

Full Text Available The number of patients starting dialysis is increasing world wide. Unplanned dialysis starts (patients urgently starting dialysis in hospital is associated with increased costs and high morbidity and mortality. Risk factors for starting dialysis urgently in hospital have not been well studied. The primary objective of this study was to identify risk factors for unplanned dialysis starts in patients followed in a multidisciplinary chronic kidney disease (CKD clinic. We performed a retrospective cohort study of 649 advanced CKD patients followed in a multidisciplinary CKD clinic at a tertiary care hospital from January 01, 2010 to April 30, 2013. Patients were classified as unplanned start (in hospital or elective start. Multivariable logistic regression was used to identify variables associated with unplanned dialysis initiation. 184 patients (28.4% initiated dialysis, of which 76 patients (41.3% initiated dialysis in an unplanned fashion and 108 (58.7% starting electively. Unplanned start patients were more likely to have diabetes (68.4% versus 51.9%; p = 0.04, CAD (42.1% versus 24.1%; p = 0.02, congestive heart failure (36.8% versus 17.6%; p = 0.01, and were less likely to receive modality education (64.5% vs 89.8%; p < 0.01 or be assessed by a surgeon for access creation (40.8% vesrus 78.7% p < 0.01. On multivariable analysis, higher body mass index (OR 1.07, 95% CI 1.02, 1.13, and a history of congestive heart failure (OR 2.41, 95% CI 1.09, 5.41 were independently associated with an unplanned start. Unplanned dialysis initiation is common among advanced CKD patients, even if they are followed in a multidisciplinary chronic kidney disease clinic. Timely education and access creation in patients at risk may lead to lower costs and less morbidity and mortality.

Effects of nutritional supplementation for HIV patients starting antiretroviral treatment

DEFF Research Database (Denmark)

Olsen, Mette Frahm; Abdissa, Alemseged; Kæstel, Pernille

2014-01-01

Objectives: To determine the effects of lipid based nutritional supplements with either whey or soy protein in patients with HIV during the first three months of antiretroviral treatment (ART) and to explore effects of timing by comparing supplementation at the start of ART and after three months....../µL (−2 to 53 cells/µL) were CD4. Effects of the soy containing supplement on immune recovery were not significant. The effects of the two supplements, however, were not significantly different in direct comparison. Exploratory analysis showed that relatively more lean body mass was gained by patients...... with undetectable viral load at three months. Patients receiving delayed supplementation had higher weight gain but lower gains in functional outcomes. Conclusions: Lipid based nutritional supplements improved gain of weight, lean body mass, and grip strength in patients with HIV starting ART. Supplements...

Dialysis access, infections, and hospitalisations in unplanned dialysis start patients

DEFF Research Database (Denmark)

Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy

2017-01-01

Introduction: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient ou...

European pharmacy students' experience with virtual patient technology.

Science.gov (United States)

Cavaco, Afonso Miguel; Madeira, Filipe

2012-08-10

To describe how virtual patients are being used to simulate real-life clinical scenarios in undergraduate pharmacy education in Europe. One hundred ninety-four participants at the 2011 Congress of the European Pharmaceutical Students Association (EPSA) completed an exploratory cross-sectional survey instrument. Of the 46 universities and 23 countries represented at the EPSA Congress, only 12 students from 6 universities in 6 different countries reported having experience with virtual patient technology. The students were satisfied with the virtual patient technology and considered it more useful as a teaching and learning tool than an assessment tool. Respondents who had not used virtual patient technology expressed support regarding its potential benefits in pharmacy education. French and Dutch students were significantly less interested in virtual patient technology than were their counterparts from other European countries. The limited use of virtual patients in pharmacy education in Europe suggests the need for initiatives to increase the use of virtual patient technology and the benefits of computer-assisted learning in pharmacy education.

The European standard series in 9 European countries, 2002/2003 - First results of the European Surveillance System on Contact Allergies

NARCIS (Netherlands)

Uter, W; Hegewald, J; Aberer, W; Ayala, F; Bircher, AJ; Brasch, J; Coenraads, PJ; Schuttelaar, Marielouise; Elsner, P; Fartasch, M; Mahler, V.; Fortina, AB; Frosch, PJ; Fuchs, T; Johansen, JD; Menne, T; Jolanki, R; Krecisz, B; Kiec-Swierczynska, M; Larese, F; Orton, D; Peserico, A; Rantanen, T; Schnuch, A

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series,

Economic costs of chemotherapy-induced febrile neutropenia among patients with non-Hodgkin’s lymphoma in European and Australian clinical practice

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Weycker Derek

2012-08-01

Full Text Available Abstract Background Economic implications of chemotherapy-induced febrile neutropenia (FN in European and Australian clinical practice are largely unknown. Methods Data were obtained from a European (97% and Australian (3% observational study of patients with non-Hodgkin’s lymphoma (NHL receiving CHOP (±rituximab chemotherapy. For each patient, each cycle of chemotherapy within the course, and each occurrence of FN within cycles, was identified. Patients developing FN in a given cycle (“FN patients”, starting with the first, were matched to those who did not develop FN in that cycle (“comparison patients”, irrespective of subsequent FN events. FN-related healthcare costs (£2010 were tallied for the initial FN event as well as follow-on care and FN events in subsequent cycles. Results Mean total cost was £5776 (95%CI £4928-£6713 higher for FN patients (n = 295 versus comparison patients, comprising £4051 (£3633-£4485 for the initial event and a difference of £1725 (£978-£2498 in subsequent cycles. Among FN patients requiring inpatient care (76% of all FN patients, mean total cost was higher by £7259 (£6327-£8205, comprising £5281 (£4810-£5774 for the initial hospitalization and a difference of £1978 (£1262-£2801 in subsequent cycles. Conclusions Cost of chemotherapy-induced FN among NHL patients in European and Australian clinical practice is substantial; a sizable percentage is attributable to follow-on care and subsequent FN events.

The Helsinki Declaration on Patient Safety in Anesthesiology: a way forward with the European Board and the European Society of Anesthesiology.

Science.gov (United States)

Petrini, F; Solca, M; De Robertis, E; Peduto, V A; Pasetto, A; Conti, G; Antonelli, M; Pelosi, P

2010-11-01

Anesthesiology, which includes anaesthesia, perioperative care, intensive care medicine, emergency medicine and pain therapy, is acknowledged as the leading medical specialty in addressing issues of patient safety, but there is still a long way to go. Several factors pose hazards in Anesthesiology, like increasingly older and sicker patients, more complex surgical interventions, more pressure on throughput, as well as new drugs and devices. To better design educational and research strategies to improve patient safety, the European Board of Anesthesiology (EBA) and the European Society of Anesthesiology (ESA) have produced a blueprint for patient safety in Anesthesiology. This document, to be known as the Helsinki Declaration on Patient Safety in Anesthesiology, was endorsed together with the World Health Organization (WHO), the World Federation of Societies of Anesthesiologists (WFSA), and the European Patients' Federation (EPF) at the Euroanaesthesia meeting in Helsinki in June 2010. It was signed by several Presidents of National Anesthesiology Societies as well as other stakeholders. The Helsinki Declaration on Patient Safety in Anesthesiology represents a shared European view of what is necessary to improve patient safety, recommending practical steps that all anesthesiologists can include in their own clinical practice. The Italian Society of Anaesthesia, Analgesia, Reanimation and Intensive Care (SIAARTI) is looking forward to continuing work on "patient safety" issues in Europe, and to cooperating with the ESA in the best interest of European patients.

Offering Patients Therapy Options in Unplanned Start (OPTiONS)

DEFF Research Database (Denmark)

Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy

2017-01-01

-EP. Among 177 patients who chose dialysis modality after UPS-EP, 103 (58%) chose PD (but only 86% of them received PD) and 74 (42%) chose HD (95% received HD). Logistic regression analysis showed that diabetes 1.88 (1.05 - 3.37) and receiving UPS-EP, OR = 4.74 (CI, 2.05 - 10.98) predicted receipt of PD...... pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. Methods: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European....... Peritonitis and bacteraemia rates were better than international guideline standards. Conclusions: UPS-EP predicted patient use of PD but 14% of those choosing PD after UPS-EP still did not receive the modality they preferred. Patient survival in patients choosing and/or receiving PD was similar to HD despite...

Mortality risk in European children with end-stage renal disease on dialysis

DEFF Research Database (Denmark)

Chesnaye, Nicholas C.; Schaefer, Franz; Groothoff, Jaap W.

2016-01-01

We aimed to describe survival in European pediatric dialysis patients and compare the differential mortality risk between patients starting on hemodialysis (HD) and peritoneal dialysis (PD). Data for 6473 patients under 19 years of age or younger were extracted from the European Society of Pediat...... dialysis (HD/PD adjusted HR 6.55, 95% CI 2.35–18.28, PSM HR 2.93, 95% CI 1.04–8.23). Because unmeasured case-mix differences and selection bias may explain the higher mortality risk in the HD population, these results should be interpreted with caution....

Differences in patients' perceptions of Schizophrenia between Māori and New Zealand Europeans.

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Sanders, Deanna; Kydd, Robert; Morunga, Eva; Broadbent, Elizabeth

2011-06-01

Māori (the Indigenous people of New Zealand) are disproportionately affected by mental illness and experience significantly poorer mental health compared to New Zealand Europeans. It is important to understand cultural differences in patients' ideas about mental illness in treatment settings. The aim of the present study was to investigate differences in illness perceptions between Māori and New Zealand Europeans diagnosed with schizophrenia. A total of 111 users of mental health services (68 Māori, 43 New Zealand European) in the greater Auckland and Northland areas who had been diagnosed with schizophrenia or other psychotic disorder were interviewed using the Brief Illness Perception Questionnaire and the Drug Attitude Inventory. District Health Board staff completed the Global Assessment of Functioning for each patient. Māori with schizophrenia believed that their illness would continue significantly less time than New Zealand European patients did. Chance or spiritual factors were listed as causes of mental illness by only five Māori patients and no New Zealand European patients. Other illness perceptions, as well as attitudes towards medication, were comparable between groups. Across groups, the top perceived causes were drugs/alcohol, family relationships/abuse, and biological causes. Illness perceptions provide a framework to assess patients' beliefs about their mental illness. Differences between Māori and New Zealand European patients' beliefs about their mental illness may be related to traditional Māori beliefs about mental illness. Knowledge of differences in illness perceptions provides an opportunity to design effective clinical interventions for both Māori and New Zealand Europeans.

Steady-State Clozapine and Norclozapine Pharmacokinetics in Maori and European Patients.

Science.gov (United States)

Menkes, David B; Glue, Paul; Gale, Christopher; Lam, Frederic; Hung, Cheung-Tak; Hung, Noelyn

2018-01-01

Clozapine is the most effective drug for treatment-resistant schizophrenia, but its use is limited by toxicity. Because ethnicity has been reported to affect clozapine metabolism, we compared its steady state pharmacokinetics in New Zealand Maori and European patients. Clozapine and norclozapine steady state bioavailability was assessed over 24h under fasting and fed conditions in 12 Maori and 16 European patients treated for chronic psychotic illnesses with stable once-daily clozapine doses. Plasma clozapine and norclozapine concentrations were assessed using liquid chromatography with tandem mass spectrometry; pharmacokinetic parameters were calculated using standard non-compartmental methods, and compared using unpaired t-tests. Mean pharmacokinetic parameters (AUC, C max and C min ) for clozapine and norclozapine were virtually identical in Maori and European subjects, under both fed and fasted conditions. Clozapine bioavailability does not vary between Maori and European patients, and thus does not need to be considered in prescribing decisions. Additional studies are needed to identify if there are differences between Maori and European populations for drugs metabolized by other enzyme pathways. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Factors determining when to start levodopa/carbidopa/entacapone treatment in Spanish patients with Parkinson's disease.

Science.gov (United States)

Martínez-Martín, P; Hernández, B; Ricart, J

2014-04-01

Several therapeutic options are available for the symptomatic treatment of Parkinson's disease (PD).There is no reliable information about which factors are involved in the choice of treatment. To identify factors contributing to the decision to start treatment with levodopa/carbidopa/entacapone (LCE) in patients with PD. We completed a descriptive cross-sectional retrospective multicentre study of patients with idiopathic PD receiving LCE. Clinical data were collected with special attention to factors that could potentially determine when to initiate treatment with LCE in normal clinical practice. We studied 1050 patients with a mean age of 71.3±8.7 years (58.2% men). Average time from onset of symptoms to diagnosis was 13.8±12.9 months, with a latency time of 74.5±53.6 months before starting LCE treatment. The most common initial symptoms were tremor (70.6%), reduced dexterity (43.2%) and slowness of movement (41.5%). At the start of LCE treatment, most patients were in Hoehn and Yahr stage 2 (57.5%), with an average rating of 73.4% on the Schwab & England scale. Eight hundred twenty two patients (78.3%) received treatment with other drugs before starting LCE (mean time between starting any PD treatment and starting LCE was 40.5±47.2 months). Clinical factors with a moderate, marked, or crucial effect on the decision to start LCE treatment were bradykinesia (84.7%), daytime rigidity (72.2%), general decline (72.2%), difficulty walking (66.4%), tremor (62.7%), nocturnal rigidity (56.1%), and postural instability (53%). Difficulty performing activities of daily living was the only psychosocial factor identified as having an influence on the decision (84.3%). The decision to start patients with idiopathic PD on LCE treatment is mainly determined by motor deficits and disabilities associated with disease progression. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

The European Natural Gas Market

NARCIS (Netherlands)

Correlje, A.F.

The European Union started the introduction of competition in the European market for natural gas. Today, mid-2016, the process of restructuring is still going on. In parallel, important changes in geopolitical, environmental and technological determinants can be observed in the European and global

Patients' perceptions and illness severity at start of antidepressant treatment in general practice

NARCIS (Netherlands)

Van Geffen, Erica C.G.; Heerdink, Eiebert R.; Hugtenburg, Jacqueline G.; Siero, Frans W.; Egberts, Antoine C.G.; Van Hulten, Rolf

2010-01-01

Objectives Patients' perceptions are important to consider when trying to understand why patients often do not follow prescriptions for antidepressant treatment. This study aimed to investigate the influence of patients' perceptions and illness severity at the start on antidepressant-medication-

Central Nervous System Strongyloidiasis and Cryptococcosis in an HIV-Infected Patient Starting Antiretroviral Therapy

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Mónica Rodríguez

2012-01-01

Full Text Available We report a case of Strongyloides stercoralis hyperinfection syndrome with central nervous system involvement, in a patient with late human immunodeficiency virus (HIV infection starting antiretroviral therapy, in whom Strongyloides stercoralis larvae and Cryptococcus neoformans were isolated antemortem from cerebrospinal fluid. Our patient was not from an endemic region for the parasite, so strongyloidiasis was not originally suspected. For this reason, we conclude that Strongyloides stercoralis infection should be suspected in HIV-infected patients starting antiretroviral therapy in order to avoid potential fatal outcomes.

European ancestry predominates in neuromyelitis optica and multiple sclerosis patients from Brazil.

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Doralina Guimarães Brum

Full Text Available BACKGROUND: Neuromyelitis optica (NMO is considered relatively more common in non-Whites, whereas multiple sclerosis (MS presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs to estimate the genetic ancestry contribution to NMO patients. METHODS: Twelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP, Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP. PRINCIPAL FINDINGS: European ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7% patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5% patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population. CONCLUSIONS: Our findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil.

European mobility cultures

DEFF Research Database (Denmark)

Haustein, Sonja; Nielsen, Thomas A. Sick

2016-01-01

More targeted European policies promoting green travel patterns require better knowledge on differing mobility cultures across European regions. As a basis for this, we clustered the EU population into eight mobility styles based on Eurobarometer data. The mobility styles - including, for example...... positions on the path towards sustainable mobility and therefore different requirements towards European platforms and support measures, e.g. for 'Sustainable Urban Mobility Plans'. The country clusters can provide a starting point for future communication and targeting of European efforts in sustainable...

Highest clinical effectiveness of rituximab in autoantibody-positive patients with rheumatoid arthritis and in those for whom no more than one previous TNF antagonist has failed: pooled data from 10 European registries

NARCIS (Netherlands)

Chatzidionysiou, K.; Lie, E.; Nasonov, E.; Lukina, G.; Hetland, M.L.; Tarp, U.; Gabay, C.; Riel, P.L. van; Nordstrom, D.C.; Gomez-Reino, J.; Pavelka, K.; Tomsic, M.; Kvien, T.K.; Vollenhoven, R.F. van

2011-01-01

OBJECTIVE: To assess the 6-month effectiveness of the first rituximab (RTX) course in rheumatoid arthritis (RA) and to identify possible predictors of response. METHOD: 10 European registries submitted anonymised datasets (baseline, 3- and 6-month follow-up) from patients with RA who had started

Implementation of patient safety strategies in European hospitals.

Science.gov (United States)

Suñol, R; Vallejo, P; Groene, O; Escaramis, G; Thompson, A; Kutryba, B; Garel, P

2009-02-01

This study is part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project on cross-border care, investigating quality improvement strategies in healthcare systems across the European Union (EU). To explore to what extent a sample of acute care European hospitals have implemented patient safety strategies and mechanisms and whether the implementation is related to the type of hospital. Data were collected on patient safety structures and mechanisms in 389 acute care hospitals in eight EU countries using a web-based questionnaire. Subsequently, an on-site audit was carried out by independent surveyors in 89 of these hospitals to assess patient safety outputs. This paper presents univariate and bivariate statistics on the implementation and explores the associations between implementation of patient safety strategies and hospital type using the chi(2) test and Fisher exact test. Structures and plans for safety (including responsibilities regarding patient safety management) are well developed in most of the hospitals that participated in this study. The study found greater variation regarding the implementation of mechanisms or activities to promote patient safety, such as electronic drug prescription systems, guidelines for prevention of wrong patient, wrong site and wrong surgical procedure, and adverse events reporting systems. In the sample of hospitals that underwent audit, a considerable proportion do not comply with basic patient safety strategies--for example, using bracelets for adult patient identification and correct labelling of medication.

Highest clinical effectiveness of rituximab in autoantibody-positive patients with rheumatoid arthritis and in those for whom no more than one previous TNF antagonist has failed : pooled data from 10 European registries

NARCIS (Netherlands)

Chatzidionysiou, Katerina; Lie, Elisabeth; Nasonov, Evgeny; Lukina, Galina; Hetland, Merete Lund; Tarp, Ulrik; Gabay, Cem; van Riel, Piet L. C. M.; Nordstrom, Dan C.; Gomez-Reino, Juan; Pavelka, Karel; Tomsic, Matija; Kvien, Tore K.; van Vollenhoven, Ronald F.

Objective To assess the 6-month effectiveness of the first rituximab (RTX) course in rheumatoid arthritis (RA) and to identify possible predictors of response. Method 10 European registries submitted anonymised datasets (baseline, 3- and 6-month follow-up) from patients with RA who had started RTX,

Patient empowerment, an additional characteristic of the European definitions of general practice/family medicine.

Science.gov (United States)

Mola, Ernesto

2013-06-01

Growing evidence supports the inclusion of patient empowerment as a key ingredient of care for patients with chronic conditions. In recent years, several studies based on patient empowerment, have been carried out in different European countries in the context of general practice and primary care to improve management of chronic diseases. These studies have shown good results of the care model, increasing patient and health professionals' satisfaction, adherence to guidelines and to treatment, and improving clinical outcomes. In 2011, the Wonca European Council included as the twelfth characteristic of the European definitions of general practice/family medicine: 'promote patient empowerment'. The aim of this paper is to clarify the meaning of 'patient empowerment' and to explain why family medicine should be considered the most suitable setting to promote it. The inclusion of patient empowerment as one of the essential characteristics of general practice fills a conceptual gap and clearly suggests to the European health care systems a tested model to face chronic diseases: involving and empowering patients in managing their own conditions to improve health and well-being.

Steady-State Clozapine and Norclozapine Pharmacokinetics in Maori and European Patients

Directory of Open Access Journals (Sweden)

David B. Menkes

2018-01-01

Discussion: Clozapine bioavailability does not vary between Maori and European patients, and thus does not need to be considered in prescribing decisions. Additional studies are needed to identify if there are differences between Maori and European populations for drugs metabolized by other enzyme pathways.

Comparison of genotypic resistance profiles and virological response between patients starting nevirapine and efavirenz in EuroSIDA

DEFF Research Database (Denmark)

Bannister, Wendy P; Ruiz, Lidia; Cozzi-Lepri, Alessandro

2008-01-01

OBJECTIVE: To compare virological outcome and genotypic resistance profiles in HIV-1-infected patients starting non-nucleoside reverse transcriptase inhibitor (NNRTI)-containing regimens. METHODS: NNRTI-naive patients were included who started treatment with nevirapine (NVP) or efavirenz (EFV) wi...

Systematic review of patient handling activities starting in lying, sitting and standing positions.

Science.gov (United States)

Hignett, Sue

2003-03-01

Over the last 20 years a number of methods have been recommended in professional guidelines for moving patients. This review was undertaken as it was recognized that there was a need for clinical work involving handling patients (systems of work and equipment) to be based on scientific evidence. The aim of this paper is to report the methodology, search strategy and results relating to work involving the care, treatment and transfer of patients starting in lying, sitting and standing positions. An unusual philosophical stance has been taken by appraising studies within a study type rather than comparatively. This facilitated the inclusion of a wide range of study designs (quantitative and qualitative). A string search was run on eight databases and supplemented by other search strategies. A published checklist was selected and inter-rater reliability established before the main review commenced. A systematic process for inclusion, exclusion, appraisal, extraction and synthesis was undertaken. Thirty-two studies were included: nine for activities with the patient starting in a lying position and 23 for the sitting position. No studies were found with respect to patient handling activities starting in a standing position. These data were synthesized into evidence statements. The evidence statements support the use of hoists (for nonweight bearing patients), standaids, sliding sheets (double thickness rollers), lateral transfer boards, walking belts and adjustable height beds and baths. It is suggested that these items should constitute a minimum equipment list for any clinical environment where patient handling takes place on a regular basis. The lack of research relating to patient handling in standing is of particular concern and it is recommended that this area should be a high research priority to address concerns about patient handling in rehabilitation activities.

A European Research Area

International Nuclear Information System (INIS)

Caro, R.

2001-01-01

This article is a summary of the presentation of the European Commissioner, Philippe Busquen, to the European Parliament (beginning of year 2000) with the proposal and method for a revival of the Research and Development in this wider sense in the European Union. The starting point of his thesis is that Europe performs less, and more disorderly, activities in this field that her main competitors. USA and Japan. His basic proposal is a larger coordination among the european research projects, with a previous phase of informatics intoxicator among the european research centres and the cross-linked participation, real of virtual in the experiments and projects. (Author)

Immune recovery after starting ART in HIV-infected patients presenting and not presenting with tuberculosis in South Africa.

Science.gov (United States)

Schomaker, Michael; Egger, Matthias; Maskew, Mhairi; Garone, Daniela; Prozesky, Hans; Hoffmann, Christopher J; Boulle, Andrew; Fenner, Lukas

2013-05-01

We studied the immune response after starting antiretroviral treatment (ART) in 15,646 HIV-infected patients with or without tuberculosis (TB) at presentation in 3 ART programs in South Africa between 2003 and 2010. Patients presenting with TB had similar increases in CD4 cells compared with all other patients (adjusted difference 4.9 cells/µL per 6 months, 95% confidence interval: 0.2 to 9.7). Younger age, advanced clinical stage, female sex, and lower CD4 cell count at ART start were all associated with steeper CD4 slopes. In South Africa, HIV-infected patients presenting with TB experience immune recovery after starting ART that is no worse than in other patients.

Fiscal Consolidation Start and its Determinants Analysis Within European Member Countries

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Lucia Mihóková

2017-09-01

Full Text Available Purpose: The purpose of the research from the theoretical point of view is to define the "start of fiscal consolidation" and to clarify the effects of selected determinants on its initiation. The purpose of the paper, in an empirical context, is to empirically assess the impact of selected determinants on the start of consolidation in the EU member states in 1995-2015 using quantitative economics. The paper was developed within the project VEGA 1/0967/15. Methodology: The empirical assessment of the research objective is divided into four phases: (1 creation of research review using EBHC methodology, (2 identification of “start” of fiscal consolidation within selected period, (3 panel econometric analysis: model specification, quantification of model’s parameters and model verification and (4 research assessment and discussion. Within the analysis, the traditional, specific and general methods were used (systemic review according to EBHC methodology, content analysis, panel regression analysis, synthesis. Approach: Approach identifies “start” of consolidation episodes using selected identification rules. Using the panel regression analysis (OLS, FEM and REM models approach the statistically significant macroeconomic, fiscal, political and other determinants and quantification of the polarity of their impact on the fiscal consolidation start were analysed. Findings: Based on the performed econometric analysis can be stated that the start of consolidation is significantly determined by initial macroeconomic and fiscal situation in the country which are captured by the size of output gap and GDP growth as well as the size of CAPB, budget expenditure and the revenue side. Political and other determinants (such as crisis can also influence the start of consolidation episodes..

Differences in Patient Characteristics and Midterm Outcome Between Asian and European Patients Treated with Radiofrequency Ablation for Hepatocellular Carcinoma

International Nuclear Information System (INIS)

Burgmans, Mark Christiaan; Too, Chow Wei; Fiocco, Marta; Kerbert, Annarein J. C.; Lo, Richard Hoau Gong; Schaapman, Jelte J.; Erkel, Arian R. van; Coenraad, Minneke J.; Tan, Bien Soo

2016-01-01

PurposeThe aim of this study was to compare patient characteristics and midterm outcomes after RFA for unresectable Hepatocellular carcinoma (HCC) in Asian and European cohorts.Materials and MethodsThe study was based on retrospective analysis of 279 patients (mean 64.8 ± 12.1 years; 208 males) treated with RFA for de novo HCC in tertiary referral centers in Singapore and the Netherlands, with median follow-up of 28.2 months (quartiles: 13.1–40.5 months). Cumulative incidence of recurrence and death were analyzed using a competing risk model.ResultsAge was higher in the Asian group: 66.5 versus 60.1 years (p < 0.0001). The most common etiology was hepatitis B in the Asian group (48.0 %) and alcohol-induced cirrhosis in Europeans (54.4 %); p < 0.001. Asian patients had less advanced disease: 35.5, 55.0, and 3.0 %, respectively, had BCLC 0, A, and B versus 21.5, 58.2, and 15.2 % in the European group (p = 0.01). The cumulative incidences of recurrence in the Asian group at 1, 2, 3, and 5 years were 37.0, 56.4, 62.3, and 67.7 %, respectively, compared to 32.6, 47.2, 49.7, and 53.4 % in the European group (p = 0.474). At 1, 2, 3, and 5 years, the cumulative incidence rates of death in the Asian group were 2.0, 3.9, 4.9, and 4.9 %, respectively, corresponding to 7.7, 9.2, 14.1, and 21.0 % in the European group (p = 0.155).ConclusionSimilar short-term treatment outcomes are achieved with RFA in HCC patients in the South-East Asian and Northern-European populations. Midterm recurrence and death rates differ between the groups as a result of differences in baseline patient characteristics and patient selection. Our study provides insight relevant to the design of future international studies.

Differences in Patient Characteristics and Midterm Outcome Between Asian and European Patients Treated with Radiofrequency Ablation for Hepatocellular Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Burgmans, Mark Christiaan, E-mail: m.c.burgmans@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands); Too, Chow Wei, E-mail: too.chow.wei@singhealth.com.sg [Singapore General Hospital, Department of Diagnostic Radiology (Singapore); Fiocco, Marta, E-mail: m.fiocco@lumc.nl [Leiden University Medical Centre, Department of Medical Statistics and Bioinformatics (Netherlands); Kerbert, Annarein J. C., E-mail: a.kerbert@lumc.nl [Leiden University Medical Centre, Department of Hepatology and Gastroenterology (Netherlands); Lo, Richard Hoau Gong, E-mail: richard.lo.h.g@sgh.com.sg [Singapore General Hospital, Department of Diagnostic Radiology (Singapore); Schaapman, Jelte J., E-mail: j.j.schaapman@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands); Erkel, Arian R. van, E-mail: a.r.van-erkel@lumc.nl [Leiden University Medical Centre, Department of Hepatology and Gastroenterology (Netherlands); Coenraad, Minneke J., E-mail: m.j.coenraad@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands); Tan, Bien Soo, E-mail: tan.bien.soo@singhealth.com.sg [Singapore General Hospital, Department of Diagnostic Radiology (Singapore)

2016-12-15

PurposeThe aim of this study was to compare patient characteristics and midterm outcomes after RFA for unresectable Hepatocellular carcinoma (HCC) in Asian and European cohorts.Materials and MethodsThe study was based on retrospective analysis of 279 patients (mean 64.8 ± 12.1 years; 208 males) treated with RFA for de novo HCC in tertiary referral centers in Singapore and the Netherlands, with median follow-up of 28.2 months (quartiles: 13.1–40.5 months). Cumulative incidence of recurrence and death were analyzed using a competing risk model.ResultsAge was higher in the Asian group: 66.5 versus 60.1 years (p < 0.0001). The most common etiology was hepatitis B in the Asian group (48.0 %) and alcohol-induced cirrhosis in Europeans (54.4 %); p < 0.001. Asian patients had less advanced disease: 35.5, 55.0, and 3.0 %, respectively, had BCLC 0, A, and B versus 21.5, 58.2, and 15.2 % in the European group (p = 0.01). The cumulative incidences of recurrence in the Asian group at 1, 2, 3, and 5 years were 37.0, 56.4, 62.3, and 67.7 %, respectively, compared to 32.6, 47.2, 49.7, and 53.4 % in the European group (p = 0.474). At 1, 2, 3, and 5 years, the cumulative incidence rates of death in the Asian group were 2.0, 3.9, 4.9, and 4.9 %, respectively, corresponding to 7.7, 9.2, 14.1, and 21.0 % in the European group (p = 0.155).ConclusionSimilar short-term treatment outcomes are achieved with RFA in HCC patients in the South-East Asian and Northern-European populations. Midterm recurrence and death rates differ between the groups as a result of differences in baseline patient characteristics and patient selection. Our study provides insight relevant to the design of future international studies.

Feasibility of Urgent-Start Peritoneal Dialysis in Older Patients with End-Stage Renal Disease: A Single-Center Experience.

Science.gov (United States)

Jin, Haijiao; Ni, Zhaohui; Mou, Shan; Lu, Renhua; Fang, Wei; Huang, Jiaying; Hu, Chunhua; Zhang, Haifen; Yan, Hao; Li, Zhenyuan; Yu, Zanzhe

2018-01-01

Patients with end-stage renal disease (ESRD) frequently require urgent-start dialysis. Recent evidence suggests that peritoneal dialysis (PD) might be a feasible alternative to hemodialysis (HD) in these patients, including in older patients. This retrospective study enrolled patients aged > 65 years with ESRD who underwent urgent dialysis without functional vascular access or PD catheter at a single center, from January 2011 to December 2014. Patients were grouped based on their dialysis modality (PD or HD). Patients unable to tolerate PD catheter insertion or wait for PD were excluded. Each patient was followed for at least 30 days after catheter insertion. Short-term (30-day) dialysis-related complications and patient survival were compared between the 2 groups. A total of 94 patients were enrolled, including 53 (56.4%) who underwent PD. The incidence of dialysis-related complications during the first 30 days was significantly lower in PD compared with HD patients (3 [5.7%] vs 10 [24.4%], p = 0.009). Logistic regression identified urgent-start HD as an independent risk factor for dialysis-related complications compared with urgent-start PD (odds ratio 4.760 [1.183 - 19.147], p = 0.028). The 6-, 12-, 24-, and 36-month survival rates in the PD and HD groups were 92.3% vs 94.6%, 82.4% vs 81.3%, 75.7% vs 74.2%, and 69.5% vs 60.6%, respectively, with no significant differences between the groups (log-rank = 0.011, p = 0.915). Urgent-start PD was associated with fewer short-term dialysis-related complications and similar survival to urgent-start HD in older patients with ESRD. Peritoneal dialysis may thus be a safe and effective dialysis modality for older ESRD patients requiring urgent dialysis. Copyright © 2018 International Society for Peritoneal Dialysis.

Patient blood management knowledge and practice among clinicians from seven European university hospitals

DEFF Research Database (Denmark)

Manzini, P. M.; Dall'Omo, A. M.; D'Antico, S.

2018-01-01

Background and Objectives: The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. Materials and Methods: A web...

A longitudinal study of systemic inflammation and recovery of lean body mass among malnourished HIV-infected adults starting antiretroviral therapy in Tanzania and Zambia

DEFF Research Database (Denmark)

PrayGod, George; Blevins, M; Woodd, Susannah

2016-01-01

BACKGROUND/OBJECTIVES: The effects of inflammation on nutritional rehabilitation after starting antiretroviral therapy (ART) are not well understood. We assessed the relationship between inflammation and body composition among patients enrolled in the Nutritional Support for African Adults Starting...... gains. Further studies are warranted to determine whether interventions to reduce systemic inflammation will enhance gains in fat-free mass.European Journal of Clinical Nutrition advance online publication, 20 January 2016; doi:10.1038/ejcn.2015.221....

Patient safety in undergraduate radiography curricula: A European perspective

International Nuclear Information System (INIS)

England, A.; Azevedo, K.B.; Bezzina, P.; Henner, A.; McNulty, J.P.

2016-01-01

Purpose: To establish an understanding of patient safety within radiography education across Europe by surveying higher education institutions registered as affiliate members of the European Federation of Radiographer Societies (EFRS). Method: An online survey was developed to ascertain data on: programme type, patient safety definitions, relevant safety topics, specific areas taught, teaching and assessment methods, levels of teaching and curriculum drivers. Responses were identifiable in terms of educational institution and country. All 54 affiliated educational institutions were invited to participate. Descriptive and thematic analyses are reported. Results: A response rate of 61.1% (n = 33) was achieved from educational institutions representing 19 countries. Patient safety topics appear to be extremely well covered across curricula, however, topics including radiation protection and optimisation were not reported as being taught at an ‘advanced level’ by five and twelve respondents, respectively. Respondents identified the clinical department as the location of most patient safety-related teaching. Conclusions: Patient safety topics are deeply embedded within radiography curricula across Europe. Variations exist in terms of individual safety topics including, teaching and assessment methods, and the depth in which subjects are taught. Results from this study provide a baseline for assessing developments in curricula and can also serve as a benchmark for comparisons. - Highlights: • First European report on patient safety (PS). • PS deeply embedded within training curricula. • Terms and definitions largely consistent. • Some variety in the delivery and assessment methods. • Report provides baseline and opportunities for comparisons.

[Satisfaction of patients with type 2 diabetes mellitus after starting treatment with insulin].

Science.gov (United States)

Mancera-Romero, J; Carramiñana-Barrera, F; Muñoz-González, L; Guillén-Álvarez, P; Murillo-García, D; Sánchez-Pérez, M R

2016-01-01

The objective of this study is to evaluate if overcoming the barrier of starting treatment with insulin can lead to better clinical control and a higher level of patient satisfaction with their treatment. This is an observational, multicentre study of patients diagnosed with DM2 who attended primary care centres with poor glycaemic control (A1c≥8%) under treatment with oral antidiabetic drugs (OADs), and who were given motivational treatment to overcome their fear of injections, and started treatment with insulin. The level of satisfaction with the treatment was evaluated using the Diabetes Treatment Satisfaction Questionnaire (DTSQ). The questionnaire was used before initiating the treatment with insulin and in the follow-up visit (3-4 months from the beginning of treatment with basal insulin). A total of 573 patients with a mean age of 64±10 years were recruited. The overall mean score from the DTSQs satisfaction questionnaire was 18.3±6.3, and the change of treatment led to an improvement in patient satisfaction compared to the previous treatment (DTSQc mean score 8.8±5.9). A1c dropped from an initial value of 8.7% (SD 0.8) to 7.5% (SD 0.7) (P<.001). The frequency of hyperglycaemic episodes perceived by the patients was significantly lower after they overcame their fear of injections (35.6% compared to 11.5%; P<.001), but no statistically significant differences were found in the frequency of hypoglycaemic episodes (32% compared to 35%; P=.059). In patients with DM2 poorly controlled with OADs, overcoming a fear of injections and starting treatment with insulin was associated with an overall improvement in satisfaction with the new treatment, and decreased the perception of hyperglycaemic episodes. Glycaemic control and the metabolic profile of the patients also improved to a statistically significant degree with the change of treatment. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S

De-isolation of patients with pulmonary tuberculosis after start of treatment - clear, unequivocal guidelines are missing

DEFF Research Database (Denmark)

Petersen, Eskild; Khamis, Faryal; Migliori, Giovanni Battista

2017-01-01

The study review guidelines on isolation of patients with tuberculosis, TB, from the World Health Organization, WHO, Centers for Disease Control and Prevention, CDC, and the European Center for Disease Control, ECDC. The review found that unequivocal guidelines for removing patients out of negative...

Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy

DEFF Research Database (Denmark)

Bohlius, Julia; Schmidlin, Kurt; Costagliola, Dominique

2009-01-01

OBJECTIVE: We examined survival and prognostic factors of patients who developed HIV-associated non-Hodgkin lymphoma (NHL) in the era of combination antiretroviral therapy (cART). DESIGN AND SETTING: Multicohort collaboration of 33 European cohorts. METHODS: We included all cART-naive patients......-seven patients (72%) from 22 cohorts met inclusion criteria. Survival at 1 year was 66% [95% confidence interval (CI) 63-70%] for systemic NHL (n = 763) and 54% (95% CI: 43-65%) for primary brain lymphoma (n = 84). Risk factors for death included low nadir CD4 cell counts and a history of injection drug use...... with primary brain lymphoma. More advanced immunodeficiency is the dominant prognostic factor for mortality in patients with HIV-related NHL....

A Monetary Union in Asia? Some European Lessons

Directory of Open Access Journals (Sweden)

Wyplosz Charles

2001-12-01

Full Text Available Monetary Union in Europe has been the natural response to the combined desire of stabilizing intra-European exchange rates and of lifting permanently all capital controls. The commitment to stable exchange rate has long been rooted in policymakers’ conviction that trade integration requires precise rules which eliminate the risk of misalignments, whether imposed by the markets or arranged by the authorities. The success in maintaining fixed-but-adjustable exchange rates within the EMS and next in adopting a single currency is largely due to the patient and progressive building institutions that became the uneasy repository of those parts of national sovereignty that have been abandoned. This experience suggests three lessons for current discussions about a monetary union in Asia. First, multilateral regional exchange rate arrangements are more conducive to an effective defense than indirect approaches like basket pegs. They probably require some limits to capital mobility. Second, adopting a single currency necessitates elaborate preparations that can only be underpinned by the gradual build up of collective institutions. Third, a monetary union requires some reasonable degree of real convergence. This implies starting with a core of sufficiently homogeneous countries. At this stage, starting with a monetary union in Asia would imply reversing the European sequencing, which started with a common market, moved on to the EMS, and liberalization of capital movements.

Factors influencing person’s decision to start-up business

OpenAIRE

Žukauskas, Pranas; Stripeikis, Osvaldas

2011-01-01

Many scientists try to analyze factors influencing the business start-up process. It is obvious that in nowadays economy the level of entrepreneurship allows a country to obtain competitive advantages. The European Commission in a Green paper on "Entrepreneurship in Europe" focuses on a question about businesses growing among Europeans. At a time when governments are facing the challenge of how to revive their economies, fostering entrepreneurship could be one of the main stimuli to raise the...

Testing the START Triage Protocol: Can It Improve the Ability of Nonmedical Personnel to Better Triage Patients During Disasters and Mass Casualties Incidents ?

Science.gov (United States)

Badiali, Stefano; Giugni, Aimone; Marcis, Lucia

2017-06-01

START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group). The START group received last-minute START training. Each group examined 6000 patients, obtained from the Emergo Train System (ETS Italy, Bologna, Italy) victims database, and assigned patients a triage code (black-red-yellow-green) along with a reason for the assignment. Each rescuer triaged 30 patients within a 30-minute time frame. Results were analyzed according to Fisher's exact test for a P valueSTART group completed the evaluations in 15 minutes, whereas the non-START group took 30 minutes. The START group correctly triaged 94.2% of their patients, as opposed to 59.83% of the non-START group (PSTART group versus 13.67% and 26.5% for the non-START group. The non-START group had 458 "preventable deaths" on 6000 cases because of incorrect triage, whereas the START group had 91. Even a "last-minute" training on the START triage protocol allows nonmedical personnel to better identify and triage the victims of a disaster or MCI, resulting in more effective and efficient medical intervention. (Disaster Med Public Health Preparedness. 2017;11:305-309).

The European radon mapping project

International Nuclear Information System (INIS)

Bossew, P.; Tollefsen, T.; Gruber, V.; De Cort, M.

2013-01-01

There is almost unanimous agreement that indoor radon (Rn) represents a hazard to human health. Large-scale epidemiological studies gave evidence that Rn is the second-most important cause o flung cancer after smoking and that also relatively low Rn concentrations can be detrimental. This has increasingly led to attempts to limit Rn exposure through regulation, mainly building codes. The proposed Euratom Basic Safety Standards (BSS) require Member States to establish Rn action plans aimed at reducing Rn risk, and to set reference values for Imitating indoor Rn concentration. In 2006 the JRC started a project on mapping Rn at the European level, in addition and complementary lo (but not as a substitute for) national efforts. These maps are part of the European Atlas of Natural Radiation project. which is planned eventually 10 comprise geographical assessments of ali sources of exposure to natural radiation. Started first, a map of indoor Rn is now in an advanced phase, but still incomplete as national Rn surveys are ongoing in a number of European countries. A European map of geogenic Rn, conceptually and technically more complicated, was started in 2008. The main difficulty encountered is heterogeneity of survey designs, measurement and evaluation methods and database semantics and structures. An important part or the work on the Atlas is therefore to harmonize data and methods. We present the current state of the Rn maps and discuss some of the methodological challenges. (author)

The European radon mapping project

Energy Technology Data Exchange (ETDEWEB)

Bossew, P., E-mail: pbossew@bfs.de [German Federal Office for Radiation Protection, Berlin (Germany); Tollefsen, T.; Gruber, V.; De Cort, M., E-mail: tore.tollefsen@jrc.ec.europa.eu, E-mail: valeria.gruber@gmail.com, E-mail: marc.de-cort@jrc.ec.europa.eu [Institute for Transuranium Elements, Ispra, VA (Italy). DG Joint Research Centre. European Commission

2013-07-01

There is almost unanimous agreement that indoor radon (Rn) represents a hazard to human health. Large-scale epidemiological studies gave evidence that Rn is the second-most important cause o flung cancer after smoking and that also relatively low Rn concentrations can be detrimental. This has increasingly led to attempts to limit Rn exposure through regulation, mainly building codes. The proposed Euratom Basic Safety Standards (BSS) require Member States to establish Rn action plans aimed at reducing Rn risk, and to set reference values for Imitating indoor Rn concentration. In 2006 the JRC started a project on mapping Rn at the European level, in addition and complementary lo (but not as a substitute for) national efforts. These maps are part of the European Atlas of Natural Radiation project. which is planned eventually 10 comprise geographical assessments of ali sources of exposure to natural radiation. Started first, a map of indoor Rn is now in an advanced phase, but still incomplete as national Rn surveys are ongoing in a number of European countries. A European map of geogenic Rn, conceptually and technically more complicated, was started in 2008. The main difficulty encountered is heterogeneity of survey designs, measurement and evaluation methods and database semantics and structures. An important part or the work on the Atlas is therefore to harmonize data and methods. We present the current state of the Rn maps and discuss some of the methodological challenges. (author)

Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

Energy Technology Data Exchange (ETDEWEB)

Cattaneo, Richard [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Hanna, Rabbie K. [Division of Gynecologic Oncology, Department of Women' s Health Services, Henry Ford Hospital, Detroit, Michigan (United States); Jacobsen, Gordon [Public Health Science, Henry Ford Hospital, Detroit, Michigan (United States); Elshaikh, Mohamed A., E-mail: melshai1@hfhs.org [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States)

2014-03-15

Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval on recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after

The European standard series in 9 European countries, 2002/2003 -- first results of the European Surveillance System on Contact Allergies

DEFF Research Database (Denmark)

Uter, W; Hegewald, J; Aberer, W

2005-01-01

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series...... observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2......-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe....

[DIETARY INTAKE AND NUTRITIONAL STATUS IN ONCOLOGY PATIENTS WHO START TREATMENT WITH TYROSINE KINASE INHIBITORS].

Science.gov (United States)

Higuera-Pulgar, Isabel; Ribed, Almudena; Carrascal-Fabian, M Luisa; Bretón-Lesmes, Irene; Romero-Jiménez, Rosa M; Cuerda-Compes, Cristina; Velasco-Gimeno, Cristina; Camblor-Álvarez, Miguel; García-Peris, Pilar

2015-09-01

in recent years, researching about new oral antineoplastics has progressed while its impact on dietary intake and nutritional status (NS) hasn't developed enough yet. dietary intake and NS assessment in patients who start treatment with tyrosine kinase inhibitors (TKI) and evaluate its impact on them. an observational, prospective-six-months study, in which were included patients starting treatment with TKI. The intake was evaluated by a 24 h dietary record and a food frequency questionnaire. The NS was evaluated by anthropometric measurements and the patient-generated Global Subjective Assessment (PG-GSA); the results were compared with the Spanish references (SENC-semFYC, 2007 and O. Moreiras, 2013). Friedman test, χ2, Wilcoxon, Kruskal-Wallis and Mann-Whitney were used in the statistical analysis. Significance p Weight loss was no significant, although a high percentage of the energy and protein requirements hadn't been reached. The caloric intake was positively related with the number of meals. Dietary habits did not change during treatment. dietary intake did not reach nutritional requirements at baseline. The TKI don't seem to affect the patient's intake and nutritional status. The research about these parameters before starting treatment could prevent future complications and it would guide the dietary advice. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

European origin of patients with Paget's disease of bone in the Buenos Aires area

International Nuclear Information System (INIS)

Gomez Acotto, C.; Mautalen, C.A.

2001-01-01

Paget's bone disease is heterogeneously distributed and several foci of high prevalence have been reported in Europe, United States, Argentina and Australia. The aim of the present work was to determine the ethnic origin of the disease in Buenos Aires using a cross sectional epidemiological study. Sample choice was based on a sampling according to grandparents' nationality. Ninety five percent of Paget patients were of European descent and 5% were non-European, while in the control group the proportion of European descendants is lower: 83% (OR: 3.7; p < 0.007; IC 95%: 1.4-9.7). Within the group of patients with Paget's disease the proportion of Italian and Russian descendants was higher than expected according to the 1914 Argentinean census. The prevalence of Paget's disease among European migrants was higher than in the control group of citizens. Regardless of environmental factors, it is likely that the migrants carried a higher risk of developing the disease

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

DEFF Research Database (Denmark)

Oonk, Maaike H M; Planchamp, François; Baldwin, Peter

2017-01-01

OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological...... Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe). To ensure that the statements are evidence...

Patient Blood Management in Europe

DEFF Research Database (Denmark)

Bruun, M T; Pendry, K; Georgsen, J

2016-01-01

BACKGROUND AND OBJECTIVES: Patient Blood Management (PBM) in Europe is a working group of the European Blood Alliance with the initial objective to identify the starting position of the participating hospitals regarding PBM for benchmarking purposes, and to derive good practices in PBM from...

The European Cancer Patient's Bill of Rights, update and implementation 2016

DEFF Research Database (Denmark)

Højgaard, Liselotte; Löwenberg, Bob; Selby, Peter

2016-01-01

.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis...... of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control...... on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically...

Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists

NARCIS (Netherlands)

Hifinger, M.; Hiligsmann, M.; Ramiro, S.; Watson, V.; Severens, J. L.; Fautrel, B.; Uhlig, T.; van Vollenhoven, R.; Jacques, P.; Detert, J.; Canas da Silva, J.; Scirè, C. A.; Berghea, F.; Carmona, L.; Péntek, M.; Keat, A.; Boonen, A.

2017-01-01

To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with

The 2002 Starting Artificial Intelligence Researchers Symposium

OpenAIRE

Vidal, Thierry

2003-01-01

During the 2002 European Conference on Artificial Intelligence (ECAI-02) was introduced the Starting Artificial Intelligence Researchers Symposium STAIRS), the first-ever international symposium specifically aimed at Ph.D. students in AI. The outcome was a thorough, high-quality, and successful event, with all the features one usually finds in the best international conferences: large international committees, comprehensive coverage, published proceedings, renowned speakers and panelists, sub...

[Inappropriate prescription in older patients: the STOPP/START criteria].

LENUS (Irish Health Repository)

Delgado Silveira, Eva

2009-09-01

Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

Common lessons drawn from different laboratories analyses of super-phenix start-up experiments

International Nuclear Information System (INIS)

Cabrillat, J.C.; Salvatores, M.; Carta, M.; D'Angelo, A.; Giese, H.; De Wouters, R.; Newton, T.; Harrison, P.; Sztark, H.; Wehmann, U.

1990-01-01

Measurements issued from the SUPER-PHENIX start-up experiments have been analysed by the different partners within the European Community with their own data and methods. Common lessons can be drawn from the different analyses and recommendations made on the definition of the characteristics of a common European formulaire and in the actions in support of its qualification

Psychological aspects met in the start-up stage of entrepreneurial activity

Directory of Open Access Journals (Sweden)

Robert Gabriel DRAGOMIR

2012-06-01

Full Text Available The present paper proposes to focus on the important psychological characteristics implied in the activity of start-up a business. At the beginning, we present the definition and the specific points of an entrepreneur and also of an entrepreneurial activity. Then we restrict the sphere to the psychological aspects connected to the start-up business activity: the courage, the self trust, the independence attitude, the intuition, the professional training and the environment knowledge, the ability of adapting, the great availability for work, the perseverance, good organiser, a good communicator, respect for the collaborators, positive thinking, socially active. In the end, we jump at the conclusions and talked about the importance and the roles of the projects financed by the European Union, the Romanian Government, the Social European Fund and Structural Instruments.

First steps towards a European atlas of natural radiation: status of the European indoor radon map

International Nuclear Information System (INIS)

Dubois, G.; Bossew, P.; Tollefsen, T.; De Cort, M.

2010-01-01

Within the context of its institutional scientific support to the European Commission, in 2005 the Radioactivity Environmental Monitoring (REM) group at the Joint Research Centre of the European Commission, started to explore the possibility of mapping indoor radon in European houses as a first step towards preparing a European Atlas of Natural Radiations. The main objective of such an atlas is to contribute to familiarizing the public with its naturally radioactive environment. The process of preparing the atlas should also provide the scientific community with a database of information that can be used for further studies and for highlighting regions with elevated levels of natural radiation. This document presents the status of the European indoor radon (Rn) map, first statistical results, and outlines of forthcoming challenges.

Predictors of work disability after start of anti-TNF therapy in a national cohort of Swedish patients with rheumatoid arthritis: does early anti-TNF therapy bring patients back to work?

Science.gov (United States)

Olofsson, T; Petersson, I F; Eriksson, J K; Englund, M; Nilsson, J A; Geborek, P; Jacobsson, L T H; Askling, J; Neovius, M

2017-07-01

To examine predictors of work ability gain and loss after anti-tumour necrosis factor (TNF) start, respectively, in working-age patients with rheumatoid arthritis (RA) with a special focus on disease duration. Patients with RA, aged 19-62 years, starting their first TNF inhibitor 2006-2009 with full work ability (0 sick leave/disability pension days during 3 months before bio-start; n=1048) or no work ability (90 days; n=753) were identified in the Swedish biologics register (Anti-Rheumatic Treatment In Sweden, ARTIS) and sick leave/disability pension days retrieved from the Social Insurance Agency. Outcome was defined as work ability gain ≥50% for patients without work ability at bio-start and work ability loss ≥50% for patients with full work ability, and survival analyses conducted. Baseline predictors including disease duration, age, sex, education level, employment, Health Assessment Questionnaire, Disease Activity Score 28 and relevant comorbidities were estimated using Cox regression. During 3 years after anti-TNF start, the probability of regaining work ability for totally work-disabled patients was 35% for those with disease duration start, disease duration did not predict work ability loss. Baseline disability pension was also a strong predictor of work ability gain after treatment start. A substantial proportion of work-disabled patients with RA who start anti-TNF therapy regain work ability. Those initiating treatment within 5 years of symptom onset have a more than doubled 3-year probability of regaining work ability compared with later treatment starts. This effect seems largely due to the impact of disease duration on disability pension status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The European Framework Programme under way

CERN Multimedia

2007-01-01

The new European Framework Programme - FP7 - has recently started and will offer various possibilities for CERN to participate in EU co-funded projects for research and technological development. In December 2006, the Council of the European Union (EU) formally adopted the 7th European Framework Programme for research, technological development and demonstration activities (FP7). FP7 started on 1 January 2007 and will cover the period 2007 to 2013. With a total budget of 50.5 B-Euros, FP7 is the largest Framework Programme in the history of the EU. FP7 consists of four major sub-programmes, referred to as 'Specific Programmes'. 'Cooperation' is focused on collaborative research and is divided into 10 research themes. 'Ideas' is a new EU programme for funding of frontier research in all fields of science. 'Capacities' aims at strengthening the research capacities in Europe. Finally, 'People' succeeds the previous Marie Curie Programmes and targets the development of Europe's human potential. On 22 December...

The European Framework Programme under way

CERN Multimedia

2007-01-01

The new European Framework Programme - FP7 - has recently started and will offer various possibilities for CERN to participate in EU co-funded projects for research and technological development. In December 2006, the Council of the European Union (EU) formally adopted the 7th European Framework Programme for research, technological development and demonstration activities (FP7). FP7 started on 1st January 2007 and will cover the period 2007 to 2013. With a total budget of 50.5 billion euros, FP7 is the largest Framework Programme in the history of the EU. FP7 consists of four major sub-programmes, referred to as 'Specific Programmes'. 'Cooperation' is focused on collaborative research and is divided into 10 research themes. 'Ideas' is a new EU programme for funding frontier research in all fields of science. 'Capacities' aims at strengthening the research capacities in Europe. Finally, 'People' succeeds the previous Marie Curie Programmes and targets the development of Europe's human potential. On 22 Decem...

A profile of prognostic and molecular factors in European and Māori breast cancer patients

International Nuclear Information System (INIS)

Dachs, Gabi U; Wells, J Elisabeth; Robinson, Bridget A; Kano, Maiko; Volkova, Ekaterina; Morrin, Helen R; Davey, Valerie CL; Harris, Gavin C; Cheale, Michelle; Frampton, Christopher; Currie, Margaret J

2010-01-01

New Zealand Māori have a poorer outcome from breast cancer than non-Māori, yet prognostic data are sparse. The objective of this study was to quantify levels of prognostic factors in a cohort of self-declared Māori and European breast cancer patients from Christchurch, New Zealand. Clinicopathological and survival data from 337 consecutive breast cancer patients (27 Māori, 310 European) were evaluated. Fewer tumours were high grade in Māori women than European women (p = 0.027). No significant ethnic differences were detected for node status, tumour type, tumour size, human epidermal growth factor receptor, oestrogen and progesterone receptor (ER/PR) status, or survival. In addition, tumour and serum samples from a sub-cohort of 14 Māori matched to 14 NZ European patients were analyzed by immunohistochemistry and enzyme linked immunosorbent assay for molecular prognostic factors. Significant correlations were detected between increased grade and increased levels of hypoxia inducible factor-1 (HIF-1α), glucose transporter-1 (GLUT-1), microvessel density (MVD) and cytokeratins CK5/6 (p < 0.05). High nodal status correlated with reduced carbonic anhydrase IX (CA-IX). Negative ER/PR status correlated with increased GLUT-1, CA-IX and MVD. Within the molecular factors, increased HIF-1α correlated with raised GLUT-1, MVD and CK5/6, and CK5/6 with GLUT-1 and MVD (p < 0.05). The small number of patients in this sub-cohort limited discrimination of ethnic differences. In this Christchurch cohort of breast cancer patients, Māori women were no more likely than European women to have pathological or molecular factors predictive of poor prognosis. These data contrast with data from the North Island NZ, and suggest potential regional differences

Patient-reported outcomes in European spondyloarthritis patients: a systematic review of the literature

Directory of Open Access Journals (Sweden)

Torre-Alonso JC

2018-05-01

Full Text Available Juan Carlos Torre-Alonso,1 Rubén Queiro,2 Marta Comellas,3 Luís Lizán,3,4 Carles Blanch5 1Rheumatology Department, Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Monte Naranco, Oviedo, Spain; 2Rheumatology Division, Hospital Universitario Central de Asturias (HUCA, Oviedo, Spain; 3Outcomes 10, Castellón de la Plana, Spain; 4Medicine Department, Jaime I University, Castellón de la Plana, Spain; 5Health Economics & Market Access, Novartis Pharmaceuticals, Barcelona, Spain Objective: This review aims to summarize the current literature on patient-reported outcomes (PROs in spondyloarthritis (SpA. Patients and methods: We performed a systematic literature review to identify studies (original articles and narrative and systematic reviews regarding PROs (health-related quality of life [HRQoL], satisfaction, preferences, adherence/compliance, and persistence in SpA patients published in the European Union through December 2016. International databases (Medline/PubMed, Cochrane Library, ISI Web of Knowledge, Scopus were searched using keywords in English. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine criteria. Results: A total of 26 publications met the inclusion criteria. Generally, studies indicated that SpA has a negative impact on patients’ HRQoL. In patients with ankylosing spondylitis, physical domains were more affected than emotional ones, whereas for psoriatic arthritis, both physical and psychological factors were strongly affected by the disease. Data indicated that biological agents (BAs greatly contributed to improvement in HRQoL in both ankylosing spondylitis and psoriatic arthritis patients. Findings on compliance with BAs were heterogeneous. However, persistence rates exceeded 50% irrespective of the BA administered. Results on preferences indicated that most SpA patients prefer being involved in decisions regarding their treatment and that

A European morpho-functional classification of humus forms

NARCIS (Netherlands)

Zanella, A.; Jabiol, B.; Ponge, J.F.; Waal, de R.W.; Delft, van S.P.J.

2011-01-01

In Europe an abundance of humus taxonomies exists starting with early approaches in the late 19th century. Frequently used in an international context, they do not cover all site conditions in the European area. Although having basic concepts and general lines, the European (and North American,

Assessment of dementia in ethnic minority patients in Europe: a European Alzheimer's Disease Consortium survey

DEFF Research Database (Denmark)

Nielsen, T Rune; Vogel, Asmus; Riepe, Matthias W

2011-01-01

In most European countries the ethnic minority migrant populations are currently reaching an age where dementia becomes an increasingly important issue. There is no European consensus on good clinical practice with these patient groups, who often have special needs and expectations with regard...... to dementia services....

When antithyroid drugs must be started in patients with hyperemesis gravidarum

International Nuclear Information System (INIS)

Farzad, N.; Akbar, A.; Naser, A.; Majid, M.

2009-01-01

To find out role of anti-thyroid drugs in patients with Hyperemesis gravidarum and thyroid dysfunction. One hundred thirty five patients with hyperemesis gravidarum who were admitted to obstetric and gynecology hospital were enrolled in this study. Thirty two patients were excluded because of diabetes mellitus and thyroid diseases. Hence, one hundred three patients underwent investigations including thyroid function test and beta-hCG (Human chorionic gonadotropin). Thirty five women were found with abnormal thyroid function test with FT4I (Free Thyroxin Index) 4.74 +- 0.54 and in another group (68 women) was 2.9 +- 0.39 (P<0.0001). B-hCG in first group was 59406 +-14899 miu/ml and in second group was 6750 +- m 3476 miu/mL (P<0.0001). In five patients PTU (propylthiouracil) was started due to severe sign and symptoms of hyperthyroidism. Thyroid function test was rechecked for all of 35 patients after four weeks routine therapy for hyperemesis gravidarum. Thyroid function test was normalized in 11 patients with hyperemesis graridarum but remained abnormal in 22 patients. In our study thyroid dysfunction in hyperemesis gravidarum was 35% and, 20% of patients needed anti-thyroid therapy. Routine assessment of thyroid function is necessary for women with hyperemesis gravidarum especially in patients with clinical features of hyperthyroidism. We must consider PTU (propylthouracil) in hyperemesis gravidarum with severe weight loss, vomiting and biochemical hyperthyroidism. (author)

European Union response to Fukushima. European stress tests and peer review

Energy Technology Data Exchange (ETDEWEB)

Jamet, Philippe [Autorite de Surete Nucleaire (ASN), Paris (France)

2012-07-01

Following the severe accidents which started in the Fukushima Dai-ichi NPP on 11 March 2011, the European Council requested that a comprehensive safety and risk assessment, in light of preliminary lessons learned, be performed on all EU nuclear plants. Therefore, stress tests and peer review assessing natural initiating events, the loss of safety systems and severe accident management have been performed in the 15 European Union countries with nuclear power plants as well as Switzerland and Ukraine. The final peer review report of the European Nuclear Safety Regulators Group (ENSREG) highlights four main areas for improvement to be explored across Europe: 1. Development by the Western European Nuclear Regulators' Association (WENRA), with the contribution of the best available EU expertise, of a European guidance on assessment of natural hazards and margins; 2. Importance of Periodic Safety Review to be underlined by ENSREG; 3. Expeditious implementation of the recognised measures to protect containment integrity; 4. Prevention of accidents resulting from natural hazards and limitation of their consequences. The peer review of the European stress tests was completed in April 2012. In their conclusive statement issued 26 April 2012, the national European regulators and the European Commission as European Nuclear Safety Regulators Group (ENSREG) required that follow-up would occur by way of an ENSREG action plan. Country specific action plans will be developed and peer review workshop will be organised to share lessons learned on the implementation of post-Fukushima safety improvements.

European Union response to Fukushima. European stress tests and peer review

International Nuclear Information System (INIS)

Jamet, Philippe

2012-01-01

Following the severe accidents which started in the Fukushima Dai-ichi NPP on 11 March 2011, the European Council requested that a comprehensive safety and risk assessment, in light of preliminary lessons learned, be performed on all EU nuclear plants. Therefore, stress tests and peer review assessing natural initiating events, the loss of safety systems and severe accident management have been performed in the 15 European Union countries with nuclear power plants as well as Switzerland and Ukraine. The final peer review report of the European Nuclear Safety Regulators Group (ENSREG) highlights four main areas for improvement to be explored across Europe: 1. Development by the Western European Nuclear Regulators' Association (WENRA), with the contribution of the best available EU expertise, of a European guidance on assessment of natural hazards and margins; 2. Importance of Periodic Safety Review to be underlined by ENSREG; 3. Expeditious implementation of the recognised measures to protect containment integrity; 4. Prevention of accidents resulting from natural hazards and limitation of their consequences. The peer review of the European stress tests was completed in April 2012. In their conclusive statement issued 26 April 2012, the national European regulators and the European Commission as European Nuclear Safety Regulators Group (ENSREG) required that follow-up would occur by way of an ENSREG action plan. Country specific action plans will be developed and peer review workshop will be organised to share lessons learned on the implementation of post-Fukushima safety improvements.

Epidemiology and Management of Patients With Acute Coronary Syndromes in Contemporary Real-World Practice: Evolving Trends From the EYESHOT Study to the START-ANTIPLATELET Registry.

Science.gov (United States)

Calabrò, Paolo; Gragnano, Felice; di Maio, Marco; Patti, Giuseppe; Antonucci, Emilia; Cirillo, Plinio; Gresele, Paolo; Palareti, Gualtiero; Pengo, Vittorio; Pignatelli, Pasquale; Pennacchi, Mauro; Granatelli, Antonino; De Servi, Stefano; De Luca, Leonardo; Marcucci, Rossella

2018-01-01

The epidemiology and management of patients with acute coronary syndromes (ACSs) have evolved. We aimed to describe recent demographics and therapeutic changes in the Italian ACS population. We analyzed data from 2 multicenter consecutive Italian registries (the EYESHOT [EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalised in iTalian cardiac care units] and START-ANTIPLATELET registries) enrolling patients with ACS between December 2013 and June 2016. An overall population of 3756 patients with ACS was enrolled: 2585 in the EYESHOT and 1171 in the START-ANTIPLATELET. Compared with the EYESHOT, patients in the START-ANTIPLATELET registry presented more frequently with ST-segment elevation myocardial infarction and were more often smokers and dyslipidemic (all P START-ANTIPLATELET (all P START-ANTIPLATELET compared with the EYESHOT. The START-ANTIPLATELET and EYESHOT registries provide consecutive snapshots in the contemporary management of patients with ACS in Italy, showing important changes in both demographic characteristics and treatment strategies.

STOPP/START criteria for potentially inappropriate prescribing in older people: version 2.

Science.gov (United States)

O'Mahony, Denis; O'Sullivan, David; Byrne, Stephen; O'Connor, Marie Noelle; Ryan, Cristin; Gallagher, Paul

2015-03-01

Screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria were first published in 2008. Due to an expanding therapeutics evidence base, updating of the criteria was required. We reviewed the 2008 STOPP/START criteria to add new evidence-based criteria and remove any obsolete criteria. A thorough literature review was performed to reassess the evidence base of the 2008 criteria and the proposed new criteria. Nineteen experts from 13 European countries reviewed a new draft of STOPP & START criteria including proposed new criteria. These experts were also asked to propose additional criteria they considered important to include in the revised STOPP & START criteria and to highlight any criteria from the 2008 list they considered less important or lacking an evidence base. The revised list of criteria was then validated using the Delphi consensus methodology. The expert panel agreed a final list of 114 criteria after two Delphi validation rounds, i.e. 80 STOPP criteria and 34 START criteria. This represents an overall 31% increase in STOPP/START criteria compared with version 1. Several new STOPP categories were created in version 2, namely antiplatelet/anticoagulant drugs, drugs affecting, or affected by, renal function and drugs that increase anticholinergic burden; new START categories include urogenital system drugs, analgesics and vaccines. STOPP/START version 2 criteria have been expanded and updated for the purpose of minimizing inappropriate prescribing in older people. These criteria are based on an up-to-date literature review and consensus validation among a European panel of experts. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society.

Wasp venom is appropriate for immunotherapy of patients with allergic reaction to the European hornet sting.

Science.gov (United States)

Kosnik, Mitja; Korosec, Peter; Silar, Mira; Music, Ema; Erzen, Renato

2002-02-01

To identify whether it is the yellow jacket (Vespula germanica) or European hornet (Vespa crabro) venom that induces sensitization in patients with IgE-mediated allergic reaction to the venom from the sting of a European hornet. Since these patients usually have positive skin tests and specific IgE to all vespid venoms, it would be useful to distinguish cross-reactors from non-cross-reactors to perform immunotherapy with the venom that induced the sensitization. We performed inhibition tests in 24 patients who had experienced anaphylactic reaction after being stung by a European hornet. Of 24 patients with allergic reaction after Vespa crabro sting, 17 were sensitized only to epitopes of Vespula germanica venom. Only 4 out of 24 patients were sensitized to epitopes completely cross-reactive with Dolichovespula arenaria venom. In Slovenia, the vast majority of patients with anaphylactic reaction to Vespa crabro sting seem to be sensitized to Vespula germanica venom. We consider wasp venom an appropriate immunotherapeutic agent for such patients, except for those with proven primary sensitization to specific epitopes of Vespa crabro venom. Fluorescence enzyme immunoassay inhibition should be considered a convenient tool for the identification of primary sensitization in patients allergic to vespid venoms.

Mortality in Patients with HIV-1 Infection Starting Antiretroviral Therapy in South Africa, Europe, or North America: A Collaborative Analysis of Prospective Studies

Science.gov (United States)

Boulle, Andrew; Schomaker, Michael; May, Margaret T.; Hogg, Robert S.; Shepherd, Bryan E.; Monge, Susana; Keiser, Olivia; Lampe, Fiona C.; Giddy, Janet; Ndirangu, James; Garone, Daniela; Fox, Matthew; Ingle, Suzanne M.; Reiss, Peter; Dabis, Francois; Costagliola, Dominique; Castagna, Antonella; Ehren, Kathrin; Campbell, Colin; Gill, M. John; Saag, Michael; Justice, Amy C.; Guest, Jodie; Crane, Heidi M.; Egger, Matthias; Sterne, Jonathan A. C.

2014-01-01

Background High early mortality in patients with HIV-1 starting antiretroviral therapy (ART) in sub-Saharan Africa, compared to Europe and North America, is well documented. Longer-term comparisons between settings have been limited by poor ascertainment of mortality in high burden African settings. This study aimed to compare mortality up to four years on ART between South Africa, Europe, and North America. Methods and Findings Data from four South African cohorts in which patients lost to follow-up (LTF) could be linked to the national population register to determine vital status were combined with data from Europe and North America. Cumulative mortality, crude and adjusted (for characteristics at ART initiation) mortality rate ratios (relative to South Africa), and predicted mortality rates were described by region at 0–3, 3–6, 6–12, 12–24, and 24–48 months on ART for the period 2001–2010. Of the adults included (30,467 [South Africa], 29,727 [Europe], and 7,160 [North America]), 20,306 (67%), 9,961 (34%), and 824 (12%) were women. Patients began treatment with markedly more advanced disease in South Africa (median CD4 count 102, 213, and 172 cells/µl in South Africa, Europe, and North America, respectively). High early mortality after starting ART in South Africa occurred mainly in patients starting ART with CD4 count Africa, Europe, and North America, respectively. Mortality was initially much lower in Europe and North America than South Africa, but the differences were reduced or reversed (North America) at longer durations on ART (adjusted rate ratios 0.46, 95% CI 0.37–0.58, and 1.62, 95% CI 1.27–2.05 between 24 and 48 months on ART comparing Europe and North America to South Africa). While bias due to under-ascertainment of mortality was minimised through death registry linkage, residual bias could still be present due to differing approaches to and frequency of linkage. Conclusions After accounting for under-ascertainment of mortality

Mortality in patients with HIV-1 infection starting antiretroviral therapy in South Africa, Europe, or North America: a collaborative analysis of prospective studies.

Directory of Open Access Journals (Sweden)

Andrew Boulle

2014-09-01

Full Text Available High early mortality in patients with HIV-1 starting antiretroviral therapy (ART in sub-Saharan Africa, compared to Europe and North America, is well documented. Longer-term comparisons between settings have been limited by poor ascertainment of mortality in high burden African settings. This study aimed to compare mortality up to four years on ART between South Africa, Europe, and North America.Data from four South African cohorts in which patients lost to follow-up (LTF could be linked to the national population register to determine vital status were combined with data from Europe and North America. Cumulative mortality, crude and adjusted (for characteristics at ART initiation mortality rate ratios (relative to South Africa, and predicted mortality rates were described by region at 0-3, 3-6, 6-12, 12-24, and 24-48 months on ART for the period 2001-2010. Of the adults included (30,467 [South Africa], 29,727 [Europe], and 7,160 [North America], 20,306 (67%, 9,961 (34%, and 824 (12% were women. Patients began treatment with markedly more advanced disease in South Africa (median CD4 count 102, 213, and 172 cells/µl in South Africa, Europe, and North America, respectively. High early mortality after starting ART in South Africa occurred mainly in patients starting ART with CD4 count <50 cells/µl. Cumulative mortality at 4 years was 16.6%, 4.7%, and 15.3% in South Africa, Europe, and North America, respectively. Mortality was initially much lower in Europe and North America than South Africa, but the differences were reduced or reversed (North America at longer durations on ART (adjusted rate ratios 0.46, 95% CI 0.37-0.58, and 1.62, 95% CI 1.27-2.05 between 24 and 48 months on ART comparing Europe and North America to South Africa. While bias due to under-ascertainment of mortality was minimised through death registry linkage, residual bias could still be present due to differing approaches to and frequency of linkage.After accounting for under

Quality of life in patients with schizophrenia in five European countries: the EPSILON study

NARCIS (Netherlands)

Gaite, L.; Vázquez-Barquero, J. L.; Borra, C.; Ballesteros, J.; Schene, A.; Welcher, B.; Thornicroft, G.; Becker, T.; Ruggeri, M.; Herrán, A.

2002-01-01

Objective: To compare subjective quality of life (QOL) and objective, QOL indicators in patients with schizophrenia from five European sites: Amsterdam, Copenhagen, London, Santander and Verona. Method: A representative sample of 404 patients with schizophrenia, in contact with mental health

Should patients with esophageal atresia be submitted to esophageal substitution before they start walking?

Science.gov (United States)

Tannuri, U; Tannuri, A C A

2011-01-01

Esophagocoloplasty and gastric transposition are two major methods for esophageal substitution in children with esophageal atresia, and there is broad agreement that these operations should not be performed before the children start walking. However, there are some reported advantages of performing such operations in the first months of life or in the neonatal period. In this study, we compared our experience with esophageal substitution procedures performed in walking children with esophageal atresia, with the outcomes of children who had the operation before the third month of life reported in the literature. The purpose of this study was to establish if we have to wait until the children start walking before indicating the esophageal replacement procedure. From February 1978 to October 2009, 129 children with esophageal atresia underwent esophageal replacement in our hospital (99 colonic interpositions and 30 gastric transpositions). The records of these patients were reviewed for data regarding demographics, complications (leaks, graft failures, strictures, and graft torsion), and mortality and compared with those reported in the two main articles on esophageal replacement in the neonatal period or in patients less than 3 months of age. The main complication of our casuistic was cervical anastomosis leakage, which sealed spontaneously in all except in four patients. One patient of the esophagocoloplasty group developed graft necrosis and three patients in the gastric transposition group had gastric outlet obstruction, secondary to axial torsion of the stomach placed in the retrosternal space. The long-term outcome of the patients in both groups was considered good to excellent in terms of normal weight gain, absence of dysphagia, and other gastrointestinal symptoms. The comparisons of the main complications and mortality rates in walking children with esophageal substitutions performed in the first months of life showed that the incidences of cervical

The ENDOCARE questionnaire guides European endometriosis clinics to improve the patient-centeredness of their care.

Science.gov (United States)

Dancet, E A F; Apers, S; Kluivers, K B; Kremer, J A M; Sermeus, W; Devriendt, C; Nelen, W L D M; D'Hooghe, T M

2012-11-01

How patient-centered are two included specialized endometriosis clinics relative to each other and how can they improve the patient-centeredness of their care? The validated ENDOCARE questionnaire (ECQ) reliably concluded that the adjusted overall patient-centeredness did not differ between the clinics, that each clinic was significantly more patient-centered for 2 out of 10 dimensions of patient-centered endometriosis care and that clinics 1 and 2 had to improve 8 and 13 specific care aspects, respectively. Patient-centered endometriosis care is essential to high-quality care and is defined by 10 dimensions. The ECQ was developed, validated and proved to be reliable in a European setting of self-reported endometriosis patients but had not yet been used at a clinic level for quality management. A cross-sectional survey was disseminated in 2011 to all 514 women diagnosed with endometriosis during a laparoscopy indicated for pain and/or infertility during a retrospective 2-year period (2009-2010) in two university clinics from two different European countries. In total 337 patients completed the ECQ (216 and 121 per clinic). Respondents had a mean age of 34.3 years. Three in four reported a surgical diagnosis of moderate or severe endometriosis and the majority reported surgical treatment by a multidisciplinary team. The ECQ assessed the 10 dimensions of patient-centeredness, more specifically whether the health-care performance, as perceived by patients, measured up to what is important to patients in general. The ECQ was completed by 337 respondents (response rate = 65.6%). Reliability and validity of the ECQ for use on clinic level were confirmed. Clinics did not differ in overall mean importance scores; importance rankings of the ECQ dimensions were almost identical. The overall patient-centeredness scores (PCS), adjusted for education level, did not discriminate between the clinics. However, the adjusted PCS for the dimensions 'clinic staff' and 'technical

Are we Europeans?: Correlates and the relation between national and European identity

Directory of Open Access Journals (Sweden)

Mihić Vladimir

2009-01-01

Full Text Available Researches of the correlates of the national identity are plentiful both in Serbian and foreign literature. However, in the past decade or so, a new social identity starts to make its way into the researches of the social psychologists-European identity or the sense of belonging to the Europe and the Europeans. This paper deals with the relation between national and European identity, as well as with the correlates of both of these, or one of them. The sample consisted of 451 subjects, all residents of major cities in the Vojvodina region (northern Serbia, divided into several categories-ethnicity (Serbs and Hungarians, educational level (primary and secondary school or University degree, gender and age. Several scales have been used: Cinnirela's national and European identity scale, Collective self-esteem scale, scale measuring attitudes towards the European integration-STEIN and Social dominance orientation scale-SDO. The questionnaire with the demographic characteristics has also been the part of the instrument. The research has been conducted in 2005 and 2006 in the all of the major Vojvodinian cities. Results show the relation between national and European identity is foggy, but general conclusion is that we can observe them as independent identities. The correlates of the national identity were ethnicity, high social dominance orientation, high collective self-esteem and negative attitude towards the European integrations. Correlates of the European identity were fewer: ethnicity, positive attitude towards the European integration and low social dominance orientation.

Genetic variation in CFH predicts phenytoin-induced maculopapular exanthema in European-descent patients.

Science.gov (United States)

McCormack, Mark; Gui, Hongsheng; Ingason, Andrés; Speed, Doug; Wright, Galen E B; Zhang, Eunice J; Secolin, Rodrigo; Yasuda, Clarissa; Kwok, Maxwell; Wolking, Stefan; Becker, Felicitas; Rau, Sarah; Avbersek, Andreja; Heggeli, Kristin; Leu, Costin; Depondt, Chantal; Sills, Graeme J; Marson, Anthony G; Auce, Pauls; Brodie, Martin J; Francis, Ben; Johnson, Michael R; Koeleman, Bobby P C; Striano, Pasquale; Coppola, Antonietta; Zara, Federico; Kunz, Wolfram S; Sander, Josemir W; Lerche, Holger; Klein, Karl Martin; Weckhuysen, Sarah; Krenn, Martin; Gudmundsson, Lárus J; Stefánsson, Kári; Krause, Roland; Shear, Neil; Ross, Colin J D; Delanty, Norman; Pirmohamed, Munir; Carleton, Bruce C; Cendes, Fernando; Lopes-Cendes, Iscia; Liao, Wei-Ping; O'Brien, Terence J; Sisodiya, Sanjay M; Cherny, Stacey; Kwan, Patrick; Baum, Larry; Cavalleri, Gianpiero L

2018-01-23

To characterize, among European and Han Chinese populations, the genetic predictors of maculopapular exanthema (MPE), a cutaneous adverse drug reaction common to antiepileptic drugs. We conducted a case-control genome-wide association study of autosomal genotypes, including Class I and II human leukocyte antigen (HLA) alleles, in 323 cases and 1,321 drug-tolerant controls from epilepsy cohorts of northern European and Han Chinese descent. Results from each cohort were meta-analyzed. We report an association between a rare variant in the complement factor H-related 4 ( CFHR4 ) gene and phenytoin-induced MPE in Europeans ( p = 4.5 × 10 -11 ; odds ratio [95% confidence interval] 7 [3.2-16]). This variant is in complete linkage disequilibrium with a missense variant (N1050Y) in the complement factor H ( CFH ) gene. In addition, our results reinforce the association between HLA-A*31:01 and carbamazepine hypersensitivity. We did not identify significant genetic associations with MPE among Han Chinese patients. The identification of genetic predictors of MPE in CFHR4 and CFH, members of the complement factor H-related protein family, suggest a new link between regulation of the complement system alternative pathway and phenytoin-induced hypersensitivity in European-ancestral patients. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Difference between received and expected knowledge of patients undergoing knee or hip replacement in seven European countries.

Science.gov (United States)

Klemetti, Seija; Leino-Kilpi, Helena; Cabrera, Esther; Copanitsanou, Panagiota; Ingadottir, Brynja; Istomina, Natalja; Katajisto, Jouko; Papastavrou, Evridiki; Unosson, Mitra; Valkeapää, Kirsi

2015-12-01

The purpose of the study was to examine received and expected knowledge of patients with knee/hip arthroplasty in seven European countries. The goal was to obtain information for developing empowering patient education. The data were collected (during 2009-2012) from patients (n = 943) with hip/knee arthroplasty prior to scheduled preoperative education and before discharge with the Received Knowledge of hospital patient scale (RKhp) and Expected Knowledge of hospital patient scale (EKhp). Patients' knowledge expectations were high but the level of received knowledge did not correspond to expectations. The difference between received and expected knowledge was higher in Greece and Sweden compared with Finland (p European countries. © The Author(s) 2014.

Starting lithium prophylaxis early v. late in bipolar disorder

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

2014-01-01

BACKGROUND: No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. AIMS: To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. METHOD: Nationwide registers were used to identify all patients...... with a diagnosis of bipolar disorder in psychiatric hospital settings who were prescribed lithium during the period 1995-2012 in Denmark (n = 4714). Lithium responders were defined as patients who, following a stabilisation lithium start-up period of 6 months, continued lithium monotherapy without being admitted...... to hospital. Early v. late intervention was defined in two ways: (a) start of lithium following first contact; and (b) start of lithium following a diagnosis of a single manic/mixed episode. RESULTS: Regardless of the definition used, patients who started lithium early had significantly decreased rates of non...

Strategies for the optimal timing to start renal replacement therapy in critically ill patients with acute kidney injury.

Science.gov (United States)

Bagshaw, Sean M; Wald, Ron

2017-05-01

Renal replacement therapy (RRT) is increasingly utilized to support critically ill patients with severe acute kidney injury (AKI). The question of whether and when to start RRT for a critically ill patient with AKI has long troubled clinicians. When severe complications of AKI develop, the need to commence RRT is unambiguous. In the absence of such complications but in the presence of severe AKI, the optimal time and thresholds for starting RRT are uncertain. The majority of existing data have largely been derived from observational studies. These have been limited due to confounding by indication, considerable heterogeneity in case mix and illness severity, and variably applied definitions for both AKI and for how "timing" was anchored relative to starting RRT. It is unclear whether a preemptive or earlier strategy of RRT initiation aimed largely at avoiding complications related to AKI or a more conservative strategy where RRT is started in response to developing complications leads to better patient-centered outcomes and health services use. This question has been the focus of 2 recently completed randomized trials. In this review, we provide an appraisal of available evidence, discuss existing knowledge gaps, and provide perspective on future research that will better inform the optimal timing of RRT initiation in AKI. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Patient Access to Medicines for Rare Diseases in European Countries.

Science.gov (United States)

Detiček, Andreja; Locatelli, Igor; Kos, Mitja

2018-05-01

The number of authorized orphan and non-orphan medicines for rare diseases has increased in Europe. Patient access to these medicines is affected by high costs, weak efficacy/safety evidence, and societal value. European health care systems must determine whether paying for expensive treatments for only a few patients is sustainable. This study aimed to evaluate patient access to orphan and non-orphan medicines for rare diseases in 22 European countries during 2005 to 2014. Medicines for rare diseases from the Orphanet list, authorized during 2005 to 2014, were searched for in the IMS MIDAS Quarterly Sales Data, January 2005 - December 2014 (IQVIA, Danbury, CT). The following three measures were determined for each country: number of available medicines, median time to continuous use, and medicine expenditure. A medicine was considered available if uninterrupted sales within a 1-year period were detected. From 2005 to 2014, 125 medicines were authorized and 112 were found in the search. Of those, between 70 (63%) and 102 (91%) were available in Germany, the United Kingdom, Italy, France, and the Scandinavian countries. These countries were also the fastest to enable continuous use (3-9 mo). Only 27% to 38% of authorized medicines were available in Greece, Ireland, Bulgaria, Romania, and Croatia, which took 1 to 2.6 years to begin continuous use. A country's expenditure on medicines for rare diseases in 2014 ranged between €0.2 and €31.9/inhabitant. Patient access to medicines for rare diseases varies largely across Europe. Patients in Germany, Scandinavian countries, Switzerland, France, and the United Kingdom can access larger numbers of medicines in shorter time. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Seroprevalence of Anti-HCV Antibody in Patients with Chronic Kidney Disease before Starting Dialysis Therapy

Directory of Open Access Journals (Sweden)

Fareha Jesmin Rabbi

2017-01-01

Full Text Available Background: Hepatitis C virus (HCV infection and chronic kidney disease are common and potentially serious medical problems throughout the world. In recent years, it has become clear that these two conditions are linked in several important ways. Indeed, some forms of renal diseases are precipitated by HCV infection and patients with end-stage renal disease (ESRD are at increased risk for acquiring HCV infection. Patients with chronic kidney disease typically show an impaired immune response compared with healthy individuals and also other risk factors related with treatment and management. CKD patients ultimately undergo end stage renal therapy like dialysis for their treatment and survival. Risk factors for the infections are more in dialysis period than in predialytic stages. Like other developing countries CKD patients with HCV infection are very common in our country. For this reason the CKD patients should be properly diagnosed knowing the infection status before dialysis which would help both the patient and doctor to choose their proper treatment approach. Objective: This cross-sectional study was done to know the prevalence of HCV infection in the CKD patients before starting dialysis therapy. Materials and Methods: A total of 197 patients with chronic kidney disease stage five (CKD-V before starting dialysis therapy were included as subjects of this study. Among the CKD patients anti-HCV was detected to see prevalence of hepatitis C virus infection. The patients were also tested for HBsAg to assess co-infection. After collecting all the data of different test results analyses were done by SPSS version 15.0. Results: In this study 195 (99% patients were anti-HCV negative and only two patients (1% were found positive. Conclusion: HCV infection in CKD patients before dialysis should be taken into account so that HCV negative CKD patients would not get the infection during dialysis and standard screening procedures should be taken to

Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis.

Directory of Open Access Journals (Sweden)

Luciene P Magalhães

Full Text Available Chronic kidney disease (CKD affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality.We studied 424 patients who were admitted to our service between 01/2006 and 12/2012 and were followed for 1 year. We analyzed vascular access, risk factors linked to cardiovascular disease (CVD and mineral and bone disease associated with CKD (CKD-MBD, and clinical events that occurred during the follow-up period. Factors that influenced patient survival were evaluated by Cox regression analysis.The patient mean age was 50 ± 18 years, and 58.7% of them were male. Hypertension was the main cause of primary CKD (31.8%. Major risk factors were smoking (19.6%, dyslipidemia (48.8%, and CVD (41%. Upon admission, most patients had no vascular access for hemodialysis (89.4%. Biochemical results showed that most patients were anemic with high C-reactive protein levels, hypocalcemia, hyperphosphatemia, elevated parathyroid hormone and decreased 25-hydroxy vitamin D. At the end of one year, 60 patients died (14.1%. These patients were significantly older, had a lower percentage of arteriovenous fistula in one year, and low levels of 25-hydroxy vitamin D.The combined evaluation of clinical and biochemical parameters and risk factors revealed that the mortality in urgent-start dialysis is associated with older age and low levels of vitamin D deficiency. A lack of a permanent hemodialysis access after one year was also a risk factor for mortality in this population.

Conversion to belatacept in maintenance kidney-transplant patients: A retrospective multicenter European study.

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Darres, Amandine; Ulloa, Camillo; Brakemeier, Susanne; Garrouste, Cyril; Bestard, Oriol; Del Bello, Arnaud; Sberro Soussan, Rebecca; Dürr, Michael; Budde, Klemens; Legendre, Christophe; Kamar, Nassim

2018-03-22

The use of belatacept is not yet approved for maintenance kidney-transplant patients. This retrospective multicenter European study aimed to assess the efficacy and safety of conversion to belatacept in a large cohort of patients in a real-life setting, and to identify the predictive factors for improved kidney function after the switch. Two-hundred and nineteen maintenance kidney-transplant patients from 5 European kidney-transplant centers were converted to belatacept at 21.2 (0.1-337.1) months posttransplantation, mainly because of impaired kidney function. Thirty-two patients were converted to belatacept within the first 3 months posttransplantation. The mean duration of follow-up was 21.9±20.2 months. The actuarial rate of patients still on belatacept-based therapy was 77.6%. Mean estimated glomerular-filtration rate (eGFR) increased from 32±16.4 at baseline to 38±20 mL/min/1.73 m (ppredictive factor for a significant increase in eGFR (of 5 and 10 mL/min/1.73 m at 3 and 12 months after the switch, respectively). Eighteen patients (8.2%) presented with an acute-rejection episode after conversion; 3 developed a donor-specific antibody (DSA). Overall efficacy and safety were good, including for the 35 patients that had a DSA at conversion. The conversion to belatacept was effective, especially when performed early after transplantation.

Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP)

DEFF Research Database (Denmark)

Vincent, Jean-Louis; Lefrant, Jean-Yves; Kotfis, Katarzyna

2018-01-01

Occurrence in Acutely ill Patients (SOAP) study, an observational study conducted in European intensive care units in 2002, and the Intensive Care Over Nations (ICON) audit, a survey of intensive care unit patients conducted in 2012. RESULTS: We compared the 3147 patients from the SOAP study with the 4852...... patients from the ICON audit admitted to intensive care units in the same countries as those in the SOAP study. The ICON patients were older (62.5 ± 17.0 vs. 60.6 ± 17.4 years) and had higher severity scores than the SOAP patients. The proportion of patients with sepsis at any time during the intensive...... care unit stay was slightly higher in the ICON study (31.9 vs. 29.6%, p = 0.03). In multilevel analysis, the adjusted odds of ICU mortality were significantly lower for ICON patients than for SOAP patients, particularly in patients with sepsis [OR 0.45 (0.35-0.59), p

Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria

Directory of Open Access Journals (Sweden)

Bonet M

2012-06-01

Full Text Available Objective: The aims of this study were to identify potentially inappropriate prescribing using the Beers and STOPP criteria. The START criteria were applied to detect prescription omission in the geriatric population. We compared the utility of these criteria in institutionalised older people.Methods: Descriptive study reviewing the medication and clinical records of 81 residents (aged 65 years and more by pharmacists in a nursing home in the Lleida region (Spain.Results: The mean patients’ age was 84 (SD=8 years, with an average of 5 drugs per resident (total prescriptions: 416 medicines. The Beers criteria identified potentially inappropriate medication use in 25% of patients and 48% of patients used at least 1 inappropriate medication according to STOPP criteria. The most frequent potentially inappropriate medications for both criteria were long-acting benzodiazepines and NSAIDs. START detected 58 potential prescribing omissions in 44% of patients. Calcium-vitamin D supplementation in osteoporosis was the most frequent rule (15%, but omissions corresponding to the cardiovascular system implied 23% of patients.Conclusion: The STOPP-START criteria reveal that potentially inappropriate prescribing (PIP is a highly prevalent problem among Spanish nursing home residents, and a statistically significant positive correlation was found between the number of medicines prescribed and the number of PIP detected in this study. The STOPP criteria detect a larger number of PI medications in this geriatric population than the Beers criteria. The prescribing omissions detected by the START criteria are relevant and require intervention. Pharmacists’ review of medications may help identify potentially inappropriate prescribing and, through an interdisciplinary approach, working with physicians may improve prescribing practices among geriatric residents of nursing homes.

Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary.

Science.gov (United States)

Heidbuchel, Hein; Verhamme, Peter; Alings, Marco; Antz, Matthias; Diener, Hans-Christoph; Hacke, Werner; Oldgren, Jonas; Sinnaeve, Peter; Camm, A John; Kirchhof, Paulus

2017-07-14

In 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094-2106). The document received widespread interest, not only from cardiologists but also from neurologists, geriatricians, and general practitioners, as became evident from the distribution of >350 000 copies of its pocket version (the EHRA Key Message Booklet) world-wide. Since 2013, numerous new studies have appeared on different aspects of NOAC therapy in AF patients. Therefore, EHRA updated the Practical Guide, including new information but also providing balanced guiding in the many areas where prospective data are still lacking. The outline of the original guide that addressed 15 clinical scenarios has been preserved, but all chapters have been rewritten. Main changes in the Update comprise a discussion on the definition of 'non-valvular AF' and eligibility for NOAC therapy, inclusion of finalized information on the recently approved edoxaban, tailored dosing information dependent on concomitant drugs, and/or clinical characteristics, an expanded chapter on neurologic scenarios (ischaemic stroke or intracranial haemorrhage under NOAC), an updated anticoagulation card and more specifics on start-up and follow-up issues. There are also many new flow charts, like on appropriate switching between anticoagulants (VKA to NOAC or vice versa), default scenarios for

Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists.

Science.gov (United States)

Hifinger, M; Hiligsmann, M; Ramiro, S; Watson, V; Severens, J L; Fautrel, B; Uhlig, T; van Vollenhoven, R; Jacques, P; Detert, J; Canas da Silva, J; Scirè, C A; Berghea, F; Carmona, L; Péntek, M; Keat, A; Boonen, A

2017-01-01

To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety (probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

Pressure ulcer and patient characteristics--A point prevalence study in a tertiary hospital of India based on the European Pressure Ulcer Advisory Panel minimum data set.

Science.gov (United States)

Mehta, Chitra; George, Joby V; Mehta, Yatin; Wangmo, Namgyal

2015-08-01

Pressure ulcers is a frequent problem in hospitalized patients. Several prevalence studies have been conducted across the globe. Little information is available regarding prevalence of pressure ulcers in India. The aim was to identify the prevalence of pressure ulcers in one of the tertiary hospital in northern India and the factors associated with its development. A cross sectional point prevalence study. European Pressure Ulcer Advisory Panel (EPUAP) data collection form. Ethics approval was obtained prior to start of the study. Total of 358 patients were enrolled in the study. All patients above 18 years of age admitted in intensive care units and wards were included in the study. Patients admitted in emergency, day care, coronary care unit were excluded because of their short duration of hospital stay (varies from 24 to 72 h usually). All patients admitted before midnight on the predetermined day were included. The Braden scale was used to identify the risk of developing pressure ulcers. European Pressure ulcer advisory panel (EPUAP) minimum data set was used to collect prevalence data. The overall prevalence rate was 7.8%.The sacrum and heel were more commonly affected. Grade III pressure ulcers were the most common (42.8%). The pressure ulcer prevalence rate in our hospital was lower than that published in international studies. Severe forms of pressure ulcers were commonly encountered This data provides background information that may help us in developing protocols for applying effective practices for prevention of pressure ulcers. Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

The diversity of European energy policies

International Nuclear Information System (INIS)

2013-01-01

If many European Union countries have engaged in a mutation of their energy system, the direction chosen may be different from one country to the other with different specific goals, starting from different initial energy mixes and involving different financial and industrial means. The German 'Energiewende' (the 'energy turn'), the Spanish 'Sostenibilidad Energetica' or the British 'Climate Change Bill' are unique initiatives which, without coordination, can lead to detrimental consequences on the European power system. These policies represent as many experiences to meditate on in order to identify the advantages and drawbacks of these different approaches as well as their respective impact on the European power system and on markets operation

Point Climat no. 17 'The role of the forestry sector in reducing European emissions: the European Commission starts with a tally'

International Nuclear Information System (INIS)

Bellassen, Valentin; Deheza, Mariana

2012-01-01

Among the publications of CDC Climat Research, 'Climate Briefs' presents, in a few pages, hot topics in climate change policy. This issue addresses the following points: On March 12 2012, after two years of consultations and reviews, the European Commission published a decision proposal regarding the inclusion of the land use and forestry sector in European climate policy. The aim of this proposal is to impose accounting rules that are consistent with the decisions of the United Nations Framework Convention on Climate Change (UNFCCC), and to harmonise them between Member States. Meanwhile, the issue of economic incentives aimed at guaranteeing the sector's contribution to climate mitigation is postponed until a later date

The formal-informal patient payment mix in European countries. Governance, economics, culture or all of these?

Science.gov (United States)

Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

2013-12-01

Cost-sharing for health care is high on the policy agenda in many European countries that struggle with deficits in their public budget. However, such policy often meets with public opposition, which might delay or even prevent its implementation. Increased reliance on patient payments may also have adverse equity effects, especially in countries where informal patient payments are widespread. The factors which might influence the presence of both, formal and informal payments can be found in economic, governance and cultural differences between countries. The aim of this paper is to review the formal-informal payment mix in Europe and to outline factors associated with this mix. We use quantitative analyses of macro-data for 35 European countries and a qualitative description of selected country experiences. The results suggest that the presence of obligatory cost-sharing for health care services is associated with governance factors, while informal patient payments are a multi-cause phenomenon. A consensus-based policy, supported by evidence and stakeholders' engagement, might contribute to a more sustainable patient payment policy. In some European countries, the implementation of cost-sharing requires policy actions to reduce other patient payment obligations, including measures to eliminate informal payments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

ELSY. European LFR activities

International Nuclear Information System (INIS)

Alemberti, Alessandro; Carlsson, Johan; Malambu, Edouard; Orden, Alfredo; Cinotti, Luciano; Struwe, Dankward; Agostini, Pietro; Monti, Stefano

2011-01-01

The European Lead Fast Reactor has been developed in the frame of the European lead system (ELSY) project funded by the Sixth Framework Programme of EURATOM. The project, coordinated by Ansaldo Nucleare, involved a wide consortium of European organizations. The ELSY reference design is a 600 MWe pool-type reactor cooled by pure lead. The project demonstrates the possibility of designing a competitive and safe fast critical reactor using simple engineered technical features, whilst fully complying with the Generation IV goals. The paper focuses on the main aspects of the proposed design for the European lead fast reactor highlighting the innovation of this reactor concept and overall objectives. Special attention has been dedicated to safety starting from the first step of the design development taking into account other important aspects, such as the investment protection, the compactness of the primary system as well as sustainability. The main safety features of the proposed innovative decay heat removal (DHR) systems are presented. From the beginning of 2010, and for a duration of three years, the European Commission (EC) is financing the new project Lead European Advanced Demonstration Reactor (LEADER) as part of the 7th Framework Program. This paper highlights the main objectives of the LEADER project. (author)

The European Hematology Association Roadmap for European Hematology Research

DEFF Research Database (Denmark)

Engert, Andreas; Balduini, Carlo; Brand, Anneke

2016-01-01

The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology...... research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness...... of the burden of blood disorders on European society, which purely in economic terms is estimated at €23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology...

A harmonized and efficient clinical research environment would benefit patients and enhance European competitiveness. Commentary.

Science.gov (United States)

Amato, Antonino; Aringhieri, Eugenio; Boccia, Stefania; Buccella, Filippo; Gorini, Barbara; Gramaglia, Donatella; Masetti, Riccardo; Rossi, Paolo; Pelicci, Pier Giuseppe

2017-01-01

The forthcoming implementation of the European Clinical Trial Regulation (Regulation (EU) No. 536/2014), which is expected to facilitate the conduct of clinical trials across the European Union, will require National Authorities to create the best conditions for the implementation of the new Regulation through national guidelines, so that sponsors may reconsider Europe as a prime location for planning clinical trials. During a meeting titled "Innovation in Clinical Research", an expert panel discussed potential local advances fostering competitiveness of European clinical research with representatives of the pharmaceutical industry, patient organisations and Italian regulatory agency in view of the forthcoming implementation of (EU) No. 536/2014 on clinical trials of medicinal products. In this article we summarise the findings of the meeting, describe features characterising clinical research patterns and offer some suggestions on the possible involvement of all stakeholders in order to foster research innovation and allow the timely access to novel medicines for patients.

Flood Risk Research and Warning Tools at the European Scale

NARCIS (Netherlands)

Roo, A.P.J. de; Thielen, J.; Feyen, L.; Burek, P.; Salamon, P.

2012-01-01

The floods in the rivers Meuse and Rhine in 1993 and 1995 made the European Commission realize that also at Commission level further research on floods – especially in transboundary river catchments - was necessary. This led to the start of a dedicated research project on floods at the European

Patient-reported causes of heart failure in a large European sample

DEFF Research Database (Denmark)

Timmermans, Ivy; Denollet, Johan; Pedersen, Susanne S.

2018-01-01

), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient...... distress (OR = 1.54, 95% CI = 0.94–2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40–1.01, p = 0.06). Conclusion: European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal......Background: Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods...

Patient Blood Management in Europe: surveys on top indications for red blood cell use and Patient Blood Management organization and activities in seven European university hospitals.

Science.gov (United States)

Bruun, M T; Pendry, K; Georgsen, J; Manzini, P; Lorenzi, M; Wikman, A; Borg-Aquilina, D; van Pampus, E; van Kraaij, M; Fischer, D; Meybohm, P; Zacharowski, K; Geisen, C; Seifried, E; Liumbruno, G M; Folléa, G; Grant-Casey, J; Babra, P; Murphy, M F

2016-11-01

Patient Blood Management (PBM) in Europe is a working group of the European Blood Alliance with the initial objective to identify the starting position of the participating hospitals regarding PBM for benchmarking purposes, and to derive good practices in PBM from the experience and expertise in the participating teams with the further aim of implementing and strengthening these practices in the participating hospitals. We conducted two surveys in seven university hospitals in Europe: Survey on top indications for red blood cell use regarding usage of red blood cells during 1 week and Survey on PBM organization and activities. A total of 3320 units of red blood cells were transfused in 1 week at the seven hospitals. Overall, 61% of red cell units were transfused to medical patients and 36% to surgical patients, although there was much variation between hospitals. The organization and activities of PBM in the seven hospitals were variable, but there was a common focus on optimizing the treatment of bleeding patients, monitoring the use of blood components and treatment of preoperative anaemia. Although the seven hospitals provide a similar range of clinical services, there was variation in transfusion rates between them. Further, there was variable implementation of PBM activities and monitoring of transfusion practice. These findings provide a baseline to develop joint action plans to further implement and strengthen PBM across a number of hospitals in Europe. © 2016 International Society of Blood Transfusion.

Opioid Maintenance Treatment--A Call for a Joint European Quality Care Approach.

Science.gov (United States)

Brandt, Laura; Unger, Annemarie; Moser, Laura; Fischer, Gabriele; Jagsch, Reinhold

2016-01-01

The aim of this exploratory analysis of European Quality Audit of Opioid Treatment data was to identify areas of improvement for current opioid maintenance treatment (OMT) approaches. Factors facilitating treatment entry, retention and refusal were compared between 8 European countries and between OMT patient (OMT-P) and active opioid user (AOU) sample groups. Both groups were divided into those who had never had OMT before (un-experienced OMT-P (n = 573) and AOU (n = 360)) and those who had been maintained at least once prior to this investigation (experienced OMT-P (n = 746) and AOU (n = 377)). The European comparison showed that motives for starting OMT vary distinctly between countries (p ≤ 0.001). Transnationally, experienced AOU reported concerns about their ability to follow treatment rules and negative treatment experiences as decisive reasons for staying out of OMT. Greater flexibility, less pressure to reduce their treatment dose and greater treatment structure were ranked significantly higher by experienced compared to un-experienced OMT-P as factors that might facilitate treatment retention (p ≤ 0.05). Increasing awareness of potential shortcomings of OMT delivery systems is crucial to optimally match treatment approaches to patient needs and also to reduce the considerable economic burden of addiction to society. © 2015 S. Karger AG, Basel.

Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding.

Science.gov (United States)

Hollander, Francis M; de Roos, Nicole M; Belle van Meerkerk, Gerdien; Teding van Berkhout, Ferdinand; Heijerman, Harry G M; van de Graaf, Ed A

2017-11-01

Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. This study investigated body weight, body mass index (BMI; calculated as kg/m 2 ), pulmonary function, and the presence of CF-related diabetes before and after the start of ETF. This was a retrospective observational study. Data from 26 adult patients in an outpatient setting who had end-stage CF (19 women) and had been using ETF for at least 6 months between 2000 and 2014 were analyzed. Body weight, BMI, pulmonary function (forced expiratory volume in 1 second as percent of predicted) and incidence of CF-related diabetes from 6 months before to 6 months after starting ETF. Time effects were tested with one-way analysis of variance for data that were normally distributed and the Friedman test for non-parametric data. Correlations were tested with Pearson's r or Spearman's ρ, depending on the distribution of the data. Mean body weight increased by 3.5 kg (95% CI 2.2 to 4.8 kg) after patients started ETF. In women, mean BMI decreased by 0.7 in the 6 months before the start of ETF (PETF to 25% after 6 months (P=0.0013), with similar trends in women and men. There was no correlation between changes in weight and lung function. CF-related diabetes was already present in 12 patients and developed in 1 more patient after the start of ETF. ETF improved body weight and BMI but not pulmonary function in 26 patients with end-stage CF. Clinical outcomes were similar in women and men, but the sample size of men was too small to determine statistical significance. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

European Research towards Future Wireless Communications

DEFF Research Database (Denmark)

Frederiksen, Flemming Bjerge; Prasad, Ramjee; Pedersen, Gert Frølund

2005-01-01

This paper presents an overview of four on-going European research projects in the field of mobile and wireless communications leading to the next generations of wireless communications. The projects started in 2004. They investigate requirements and definition of access technology, network...

Quality assessments for cancer centers in the European Union.

Science.gov (United States)

Wind, Anke; Rajan, Abinaya; van Harten, Wim H

2016-09-07

Cancer centers are pressured to deliver high-quality services that can be measured and improved, which has led to an increase of assessments in many countries. A critical area of quality improvement is to improve patient outcome. An overview of existing assessments can help stakeholders (e.g., healthcare professionals, managers and policy makers) improve the quality of cancer research and care and lead to patient benefits. This paper presents key aspects of assessments undertaken by European cancer centers, such as: are assessments mandatory or voluntary? Do they focus on evaluating research, care or both? And are they international or national? A survey was sent to 33 cancer centers in 28 European Union member states. Participants were asked to score the specifics for each assessment that they listed. Based on the responses from 19 cancer centers from 18 member states, we found 109 assessments. The numbers have steadily increased from 1990's till 2015. Although, a majority of assessments are on patient-care aspects (n = 45), it is unclear how many of those include assessing patient benefits. Only few assessments cover basic research. There is an increasing trend towards mixed assessments (i.e., combining research and patient-care aspects) The need for assessments in cancer centers is increasing. To improve efforts in the quality of research and patient care and to prevent new assessments that "reinvent the wheel", it is advised to start comparative research into the assessments that are likely to bring patient benefits and improve patient outcome. Do assessments provide consistent and reliable information that create added value for all key stakeholders?

Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy

DEFF Research Database (Denmark)

Wallman, Johan K; Jöud, Anna; Olofsson, Tor

2017-01-01

Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before...

Nursing care for stroke patients

DEFF Research Database (Denmark)

Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin

2018-01-01

AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death...... comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization...... of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention. RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start...

Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients.

Science.gov (United States)

Machowska, Anna; Alscher, Mark Dominik; Reddy Vanga, Satyanarayana; Koch, Michael; Aarup, Michael; Qureshi, Abdul Rashid; Lindholm, Bengt; Rutherford, Peter A

2016-01-01

Unplanned dialysis start (UPS) leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS-EP, including decision support tools and pathway improvement on dialysis modality choice. Linear regression models were used to examine the factors predicting three key steps: referral and receipt of UPS-EP, modality decision making, and actual delivery of preferred modality choice. A simple economic assessment was performed to examine the potential benefit of implementing UPS-EP in terms of dialysis costs. The majority of UPS patients could receive UPS-EP (214/270 patients) and were able to make a decision (177/214), although not all patients received their preferred choice (159/177). Regression analysis demonstrated that the initial dialysis modality was a predictive factor for referral and receipt of UPS-EP and modality decision making. In contrast, age was a predictor for referral and receipt of UPS-EP only, and comorbidity was not a predictor for any step, except for myocardial infarction, which was a weak predictor for lower likelihood of receiving preferred modality. Country practices predicted UPS-EP receipt and decision making. Economic analysis demonstrated the potential benefit of UPS-EP implementation because dialysis modality costs were associated with modality distribution driven by patient preference. Education and decision support can allow UPS patients to understand their options and choose dialysis modality, and attention needs to be focused on ensuring equity of access to educational

European energy policy: the green book

International Nuclear Information System (INIS)

Anon.

2006-01-01

Energy dependence, insecurity of supplies, rise of demand and prices, global warming: these are the characteristics of the energy situation of the 21. century. The new green book of the European Commission about 'a European strategy for a safe, competitive and durable energy' starts from this alarming status and proposes some suggestions for the building up of a new global European energy policy: realization of the European domestic energy markets (a European energy network, a priority interconnection plan for gas networks, a separation of transport and distribution activities for equitable rules, a reinforcement of the competitiveness of the European industry), a joint security of supplies between member states (redefining the EU position about strategic oil and gas reserves), a sustainable, efficient and diversified energy offer, an integrated approach to fight against global warming (improving energy efficiency, development of renewable energy sources, carbon sequestration), encouraging innovation, developing a consistent foreign policy of energy (a clear policy for the security and diversification of energy supplies, energy partnerships between producers, transit countries and other international actors). (J.S.)

The substantial burden of systemic lupus erythematosus on the productivity and careers of patients: a European patient-driven online survey.

Science.gov (United States)

Gordon, Caroline; Isenberg, David; Lerstrøm, Kirsten; Norton, Yvonne; Nikaï, Enkeleida; Pushparajah, Daphnee S; Schneider, Matthias

2013-12-01

The objective of this study was to explore the burden of SLE and its effect on patients' lives. The Lupus European Online (LEO) survey included patient-designed questions on demographics, SLE diagnosis, and the impact of SLE on careers. Three SLE-specific patient-reported outcome (PRO) questionnaires were also completed: the Lupus Quality of Life (LupusQoL), the Fatigue Severity Scale (FSS), and the Work Productivity and Activity Impairment (WPAI)-Lupus v2.0. The survey was available online in five languages from May through August 2010. All self-identified SLE participants were eligible to respond. Survey results were analysed using descriptive statistics. Multivariate linear regression explored factors contributing to impaired productivity. Of the 2070 European SLE patients completing the survey, 93.1% were women, 86.7% were aged Productivity was impaired across all WPAI domains, both at work and in general activities. Fatigue, an inability to plan and reduced physical health were significantly associated with impaired productivity. Patients whose careers were affected by SLE had worse health-related quality of life, more fatigue and worse productivity than patients whose careers were not affected. LEO survey respondents reported that SLE negatively affects their daily lives, productivity and career choices.

Validation of the Risk Prediction Models STATE-Score and START-Strategy to Guide TACE Treatment in Patients with Hepatocellular Carcinoma.

Science.gov (United States)

Mähringer-Kunz, Aline; Kloeckner, Roman; Pitton, Michael B; Düber, Christoph; Schmidtmann, Irene; Galle, Peter R; Koch, Sandra; Weinmann, Arndt

2017-07-01

Several scoring systems that guide patients' treatment regimen for transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) have been introduced, but none have gained widespread acceptance in clinical practice. The purpose of this study is to externally validate the Selection for TrAnsarterial chemoembolization TrEatment (STATE)-score and START-strategy [i.e., sequential use of the STATE-score and Assessment for Retreatment with TACE (ART)-score]. From January 2000 to September 2015, 933 patients with HCC underwent TACE at our institution. All variables needed to calculate the STATE-score and implement the START-strategy were determined. STATE comprised serum albumin, up-to-seven criteria, and C-reactive protein (CRP). ART comprised an increase in aspartate aminotransferase, the Child-Pugh score, and a radiological tumor response. Overall survival was calculated, and multivariate analysis performed. In addition, the STATE-score and START-strategy were validated using the Harrell's C-index and integrated Brier score (IBS). The STATE-score was calculated in 228 patients. Low and high STATE-scores corresponded to median survival of 14.3 and 20.2 months, respectively. Harrell's C was 0.558 and IBS 0.133. For the STATE-score, significant predictors of survival were up-to-seven criteria (p = 0.006) and albumin (p = 0.022). CRP values were not predictive (p = 0.367). The ART-score was calculated in 207 patients. Combining the STATE-score and ART-score led to a Harrell's C of 0.580 and IBS of 0.132. The STATE-score was unable to reliably determine the suitability for initial TACE. The START-strategy only slightly improved the predictive ability compared to the ART-score alone. Therefore, neither the STATE-score nor START-strategy alone provides sufficient certainty for clear-cut clinical decisions.

European master degree in nuclear engineering

International Nuclear Information System (INIS)

Ghitescu, Petre; Prisecaru, Ilie

2003-01-01

In order to preserve and to improve the quality of nuclear engineering education and training in Europe, as well to ensure the safe and economic operation of nuclear power plants, the European Nuclear Engineering Network Program (ENEN) started in 2002. It is a program aiming to establish and maintain a set of criteria for specific curricula of nuclear engineering education, in particular, for an European Master Degree in Nuclear Engineering (EMNE). The ENEN program is financed by the FP5 and has the wide support of IAEA, OECD and EU Commission departments dealing with the nuclear engineering knowledge management. The promising results up to now determined the creation of the Asian Nuclear Engineering Network (ANEN) in July 2003 and of the World Nuclear University (WNU) starting in September 2003. The paper presents the future structure of EMNE which will allow the harmonization of the curricula of the universities of Europe until the Bologna Convention will be fully accepted and operational in all European countries. The ENEN program has taken into consideration the curricula of 22 universities and research centres from 15 different European countries and proposed a feasible scheme which allows the undergraduates with a weak to strong nuclear background to continue their graduate education in the nuclear engineering field towards EMNE. As one of the contractors of this program, University 'Politehnica' of Bucharest brings its contribution and actively takes part in all activities establishing the EMNE. (author)

European legislation impedes critical care research and fails to protect patients' rights

DEFF Research Database (Denmark)

Berg, Ronan M G; Møller, Kirsten; Rossel, Peter Johannes Hancke

2011-01-01

in which a waiver of consent is deemed necessary, the Ethical Review Board should ensure that non-therapeutic risks are minimal, that the research is specifically designed to benefit critically ill patients, and that it cannot be conducted under circumstances where an informed consent can be obtained....... If the European Directive is changed accordingly, this permits clinical trials in critical care settings, while adequate protection from risky non-therapeutic procedures is ensured and exploitation of the patient as an easily accessible research subject is prevented....

Mineral metabolism in European children living with a renal transplant: a European society for paediatric nephrology/european renal association-European dialysis and transplant association registry study

NARCIS (Netherlands)

Bonthuis, Marjolein; Busutti, Marco; van Stralen, Karlijn J.; Jager, Kitty J.; Baiko, Sergey; Bakkaloğlu, Sevcan; Battelino, Nina; Gaydarova, Maria; Gianoglio, Bruno; Parvex, Paloma; Gomes, Clara; Heaf, James G.; Podracka, Ludmila; Kuzmanovska, Dafina; Molchanova, Maria S.; Pankratenko, Tatiana E.; Papachristou, Fotios; Reusz, György; Sanahuja, Maria José; Shroff, Rukshana; Groothoff, Jaap W.; Schaefer, Franz; Verrina, Enrico

2015-01-01

Data on mineral metabolism in pediatric renal transplant recipients largely arise from small single-center studies. In adult patients, abnormal mineral levels are related to a higher risk of graft failure. This study used data from the European Society for Paediatric Nephrology/European Renal

Sentinel European Node Trial (SENT)

DEFF Research Database (Denmark)

Schilling, Clare; Stoeckli, Sandro J; Haerle, Stephan K

2015-01-01

in patients with early-stage oral squamous cell carcinoma. METHODS: An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB...

Patient-Focused Benefit-Risk Analysis to Inform Regulatory Decisions: The European Union Perspective.

Science.gov (United States)

Mühlbacher, Axel C; Juhnke, Christin; Beyer, Andrea R; Garner, Sarah

Regulatory decisions are often based on multiple clinical end points, but the perspectives used to judge the relative importance of those end points are predominantly those of expert decision makers rather than of the patient. However, there is a growing awareness that active patient and public participation can improve decision making, increase acceptance of decisions, and improve adherence to treatments. The assessment of risk versus benefit requires not only information on clinical outcomes but also value judgments about which outcomes are important and whether the potential benefits outweigh the harms. There are a number of mechanisms for capturing the input of patients, and regulatory bodies within the European Union are participating in several initiatives. These can include patients directly participating in the regulatory decision-making process or using information derived from patients in empirical studies as part of the evidence considered. One promising method that is being explored is the elicitation of "patient preferences." Preferences, in this context, refer to the individual's evaluation of health outcomes and can be understood as statements regarding the relative desirability of a range of treatment options, treatment characteristics, and health states. Several methods for preference measurement have been proposed, and pilot studies have been undertaken to use patient preference information in regulatory decision making. This article describes how preferences are currently being considered in the benefit-risk assessment context, and shows how different methods of preference elicitation are used to support decision making within the European context. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary.

Science.gov (United States)

Steffel, Jan; Verhamme, Peter; Potpara, Tatjana S; Albaladejo, Pierre; Antz, Matthias; Desteghe, Lien; Georg Haeusler, Karl; Oldgren, Jonas; Reinecke, Holger; Roldan-Schilling, Vanessa; Rowell, Nigel; Sinnaeve, Peter; Collins, Ronan; Camm, A John; Heidbüchel, Hein

2018-03-19

The current manuscript is the Executive Summary of the second update to the original Practical Guide, published in 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. The European Heart Rhythm Association (EHRA) set out to co-ordinate a unified way of informing physicians on the use of the different NOACs. A writing group identified 20 topics of concrete clinical scenarios for which practical answers were formulated, based on available evidence. The 20 topics are (i) eligibility for NOACs; (ii) practical start-up and follow-up scheme for patients on NOACs; (iii) ensuring adherence to prescribed oral anticoagulant intake; (iv) switching between anticoagulant regimens; (v) pharmacokinetics and drug-drug interactions of NOACs; (vi) NOACs in patients with chronic kidney or advanced liver disease; (vii) how to measure the anticoagulant effect of NOACs; (viii) NOAC plasma level measurement: rare indications, precautions, and potential pitfalls; (ix) how to deal with dosing errors; (x) what to do if there is a (suspected) overdose without bleeding, or a clotting test is indicating a potential risk of bleeding; (xi) management of bleeding under NOAC therapy; (xii) patients undergoing a planned invasive procedure, surgery or ablation; (xiii) patients requiring an urgent surgical intervention; (xiv) patients with AF and coronary artery disease; (xv) avoiding confusion with NOAC dosing across indications; (xvi) cardioversion in a NOAC-treated patient; (xvii) AF patients presenting with acute stroke while on NOACs; (xviii) NOACs in special

Validation of the adult attention-deficit/hyperactivity disorder quality-of-life scale in European patients: comparison with patients from the USA.

Science.gov (United States)

Brod, Meryl; Adler, Lenard A; Lipsius, Sarah; Tanaka, Yoko; Heinloth, Alexandra N; Upadhyaya, Himanshu

2015-06-01

The adult attention-deficit/hyperactivity disorder (ADHD) quality-of-life (AAQoL) scale was previously validated in adult patients in the USA; here, the AAQoL is validated in adult European patients. Data from a 12-week open-label acute treatment period with atomoxetine (80-100 mg/day) in adults with ADHD were used. Patients (≥ 18 to ≤ 50 years old) had a score ≥ 2 on ≥ 6 items on the inattentive or hyperactive core subscales of Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV); a CAARS-Inv:SV 18-item total ADHD symptom score ≥ 20; and Conners' Adult ADHD Rating Scale-Observer: Screening Version 6-item inattentive or hyperactive core subscale scores ≥ 2. Data were stratified based on patients' geographic region (Europe vs USA). Scale validation psychometric properties results were very similar between European (n = 1,217; 57.7 % male; mean age 33.0 years) and US (n = 602; 62.1 % male; mean age 33.5 years) patients, including factor loading, internal consistency, convergent and discriminant validity, and responsiveness. Exploratory factor analysis confirmed four AAQoL subscales. Internal consistency was acceptable (Cronbach's alpha > 0.70 for all subscales). The AAQoL total score showed moderate convergent validity with CAARS-Inv:SV 18-item total ADHD symptom and clinical global impression-ADHD-severity (CGI-ADHD-S) scores; and strong convergent validity with Behavior Rating Inventory of Executive Function-Adult Version: Self-Report Global-Executive-Composite Index scores. Mean AAQoL total scores were significantly different among patients grouped by CGI-ADHD-S scores, suggesting good discriminant validity. The AAQoL total and subscale scores presented good responsiveness from baseline to 12 weeks. The AAQoL scale shows comparable validity in European and US adults with ADHD.

Favourable outcome in a patient bitten by a rabid bat infected with the European bat lyssavirus-1.

Science.gov (United States)

Van Gucht, S; Verlinde, R; Colyn, J; Vanderpas, J; Vanhoof, R; Roels, S; Francart, A; Brochier, B; Suin, V

2013-01-01

The classic rabies virus (genotype 1) has been eliminated in Western Europe, but related lyssaviruses still circulate in local bats. In August 2010, a Belgian photographer was bitten upon provocation of a disoriented Eptesicus serotinus bat in Spain. The bat was infected with European bat lyssavirus-1 (genotype 5). The isolate proved highly neurovirulent in mice. The patient had received preventive rabies immunisations years before the incident and received two boosters with the HDCV rabies vaccine afterwards. Available vaccines are based on the classic rabies virus, which is significantly divergent from the European bat lyssavirus-1. Fortunately, the patient's serological immune response demonstrated satisfactory neutralisation of the 2010 EBLV-1 isolate, using an intracerebral challenge model in mice. Most likely, the patient's life was saved thanks to vaccination with the classic rabies vaccine, which proved sufficiently protective against European bat lyssavirus-1. This case highlights the need for preventive rabies vaccination in people, who come in contact with bats and to seek medical council after a scratch or bite from a bat.

ENLIGHT at its second European appointment

CERN Multimedia

2006-01-01

CERN hosts the preparatory meeting of ENLIGHT++ to focus European efforts in light-ion hadron therapy. On Friday, 24 March, CERN hosted the preparatory meeting of ENLIGHT++, which continues the vision started by the European Network for Research in Light-Ion Hadron Therapy (ENLIGHT). Clinicians, oncologists, physicists, radiobiologists, information and communication technology experts and engineers from around Europe came for the one-day workshop to coordinate European efforts in radiation therapy using light-ion beams for cancer therapy. Following a welcome from CERN's Chief Scientific Officer Jos Engelen, key note presentations began with Jean-Pierre Gérard, Director-General of the Centre Antoine-Lacassagne and former chairman of the European Society for Therapeutic Radiology and Oncology (ESTRO), who illustrated the compelling reasons why ion therapy is needed. The following talks were given by Germaine Heeren, manager of the original ENLIGHT project (Belgium), and Thomas Haberer from the Heidelberg Io...

Early Head Start and African American Families: Impacts and Mechanisms of Child Outcomes

Science.gov (United States)

Harden, Brenda Jones; Sandstrom, Heather; Chazan-Cohen, Rachel

2012-01-01

Persistent disparities exist between African American children and their European American counterparts across developmental domains. Early childhood intervention may serve to promote more positive outcomes among African American children. The current study examined whether and how the Early Head Start (EHS) program benefited African American…

European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers.

Science.gov (United States)

Kotecha, Dipak; Chua, Winnie W L; Fabritz, Larissa; Hendriks, Jeroen; Casadei, Barbara; Schotten, Ulrich; Vardas, Panos; Heidbuchel, Hein; Dean, Veronica; Kirchhof, Paulus

2018-02-01

We are in the midst of a digital revolution in health care, although the application of new and useful technology in routine clinical practice is variable. The Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly (CATCH ME) Consortium, in collaboration with the European Society of Cardiology (ESC), has funded the creation of two applications (apps) in atrial fibrillation (AF) for use in smartphones and tablets. The patient app aims to enhance patient education, improve communication between patients and health care professionals, and encourage active patient involvement in the management of their condition. The health care professional app is designed as an interactive management tool incorporating the new ESC Practice Guidelines on AF and supported by the European Heart Rhythm Association (EHRA), with the aim of improving best practice approaches for the care of patients with AF. Both stand-alone apps are now freely available for Android and iOS devices though the Google Play, Amazon, and Apple stores. In this article, we outline the rationale for the design and implementation of these apps. Our objective is to demonstrate the value of integrating novel digital technology into clinical practice, with the potential for patient engagement, optimization of pharmacological and interventional therapy in AF, and ultimately to improve patient outcomes. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Cardiology.

The future of energy in the European Union

International Nuclear Information System (INIS)

Robles, C.

1997-01-01

Two of the three European Union founding treaties have a marked energy nature but, however, at the present time, the EU lacks a Common Energy Policy, Starting with this paradox, the European Parliament Member Robles Piquer uses this article, which reproduces the lecture he gave at the CSN, to proffer his view of the future of energy which the EU will have and that which it should have, in this opinion. (Author)

Southern Europeans in France: Invisible Migrants?

NARCIS (Netherlands)

Eremenko, T.; El Qadim, N.; Steichen, E.; Lafleur, J.-M.; Stanek, M.

2016-01-01

France fared relatively well at the start of the current economic crisis, but has experienced low economic growth and high unemployment rates in the recent years. As a result it has been a less popular destination with Southern Europeans and EU migrants in general in search of economic

IMPLEMENTATION OF BASEL III IN THE EUROPEAN BANKING SECTOR

Directory of Open Access Journals (Sweden)

Ioana Sbarcea

2015-06-01

Full Text Available In this work, which is part of a larger research project aimed at the expected impact of Basel III on commercial banks in Romania, I decided to analyse the implementation and transposition of the new international prudential requirements into European regulations, which are of particular interest for the Romanian banking sector. I started this analysis by highlighting the peculiarities of the European banking sector at aggregate level, but also as a cross-country survey, to later highlight the views of European regulations on prudential supervision and differences to international regulations.

CONSIDERATIONS REGARDING THE EVOLUTION OF EUROPEAN FUNDS ABSORPTION IN ROMANIA

Directory of Open Access Journals (Sweden)

IOANA TATIANA STANESE

2017-11-01

Full Text Available This paper analyzes the evolution of the absorption of European funds in Romania reported to the closure period of the operational programms related to the European Union cohesion policy during the years 2007 – 2013. This programming period officially concluded only at the end of year 2015. Considering the financial aspects of the 2007- 2013 programming period for European funds the analysis focuses exclusively on the Structural and Cohesion Funds and the absorption rate of these funds in Romania, namely 90.44%, recorded in March 2017. Nearly 3 years from the start of the new programming period 2014-2020 related to the European Union’s cohesion policy, there is a direct link between the quality of public administration’s activity and the application of the principle of investment programming. Despite a slow and difficult start, we can observe an accelerated trend over the last few hundred meters. Identifying priority projects at national and regional level, followed by a alteration and adaptation of strategic documents such as National Reform Programs, could be a solution for Romania to gain a more rigorous planning that leads to a higher and faster absorption of European funds in the current programming period 2014-2020.

European Master's program in Gerontology (EuMaG): Goals, curriculum, and students

NARCIS (Netherlands)

Aartsen, M.J.

2011-01-01

The European Master's Program in Gerontology (EuMaG) started in September 2003 with support from the European Commission. The EuMaG is a modular, 2-year, part-time international training program about the aging process and its societal implications. The multidisciplinary curriculum comprises four

EU Emission Trading: Starting with Carbon Dioxide

DEFF Research Database (Denmark)

Vesterdal, Morten; Svendsen, Gert Tinggaard

2003-01-01

The Commission of the European Union wants to start a limited emission trading scheme by 2005 within the Community to enable "learning-by-doing" prior to the Kyoto Protocol. This to accomplish the desired 8% target level for six different greenhouse gases. However, in the EU it is not clear whether...... all the six relevant greenhouse gases or only CO2 should be traded. What is the simplest and most practicable solution? We argue in favour of the latter option for three main reasons: the possible dominating global warming potential of CO2, expected future developments in CO2 emissions and the fact...

Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

DEFF Research Database (Denmark)

Haddow, Lewis J; Laverick, Rosanna; Daskalopoulou, Marina

2018-01-01

We conducted a cross-sectional study in 448 HIV positive patients attending five European outpatient clinics to determine prevalence of and factors associated with neurocognitive impairment (NCI) using computerized and pen-and-paper neuropsychological tests. NCI was defined as a normalized Z scor...

The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer.

Science.gov (United States)

Brunelli, Alessandro; Charloux, Anne; Bolliger, Chris T; Rocco, Gaetano; Sculier, Jean-Paul; Varela, Gonzalo; Licker, Marc; Ferguson, Mark K; Faivre-Finn, Corinne; Huber, Rudolf Maria; Clini, Enrico M; Win, Thida; De Ruysscher, Dirk; Goldman, Lee

2009-07-01

The European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS) established a joint task force with the purpose to develop clinical evidence-based guidelines on evaluation of fitness for radical therapy in patients with lung cancer. The following topics were discussed, and are summarized in the final report along with graded recommendations: Cardiologic evaluation before lung resection; lung function tests and exercise tests (limitations of ppoFEV1; DLCO: systematic or selective?; split function studies; exercise tests: systematic; low-tech exercise tests; cardiopulmonary (high tech) exercise tests); future trends in preoperative work-up; physiotherapy/rehabilitation and smoking cessation; scoring systems; advanced care management (ICU/HDU); quality of life in patients submitted to radical treatment; combined cancer surgery and lung volume reduction surgery; compromised parenchymal sparing resections and minimally invasive techniques: the balance between oncological radicality and functional reserve; neoadjuvant chemotherapy and complications; definitive chemo and radiotherapy: functional selection criteria and definition of risk; should surgical criteria be re-calibrated for radiotherapy?; the patient at prohibitive surgical risk: alternatives to surgery; who should treat thoracic patients and where these patients should be treated?

European working environment in figures : availability and quality of occupational health and safety data in sixteen European countries

NARCIS (Netherlands)

Nossent, S.; Groot, B. de; Verboom, F.; Pantry, S.

1996-01-01

This report by the European Foundation for the Improvement of Living and Working Conditions shows that information is essential to pinpoint risk factors in the workplace, and is a crucial starting point for the preparation of efficient measures to improve the working environment. To this end, most

Patient-reported outcomes among patients using exenatide twice daily or insulin in clinical practice in six European countries

DEFF Research Database (Denmark)

Reaney, Matthew; Mathieu, Chantal; Ostenson, Claes-Göran

2013-01-01

who did not meet this endpoint) and Diabetes Health Profile-18 scores (versus the main cohorts). High levels of missing data were observed for all PRO measures in both cohorts compared with those for clinical outcomes. CONCLUSIONS: These data from a clinical practice study support those from clinical...... clinical practice are lacking. We examined PROs in patients initiating injectable treatment in the CHOICE (CHanges to treatment and Outcomes in patients with type 2 diabetes initiating InjeCtablE therapy) study. METHODS: CHOICE was a 24-month, prospective observational study conducted in six European......BACKGROUND: Improvements in the clinical condition of patients with type 2 diabetes are often accompanied by improvements in health-related quality of life and other patient-reported outcomes (PROs), but data assessing injectable treatment initiation from the patient's perspective in routine...

Association Study for 26 Candidate Loci in Idiopathic Pulmonary Fibrosis Patients from Four European Populations

Directory of Open Access Journals (Sweden)

Amit Kishore

2016-07-01

Full Text Available Idiopathic pulmonary fibrosis (IPF affects lung parenchyma with progressing fibrosis. In this study, we aimed to replicate MUC5B rs35705950 variants and determine new plausible candidate variants for IPF among four different European populations. We genotyped 26 IPF candidate loci in 165 IPF patients from four European countries: Czech Republic (n = 41, Germany (n = 33, Greece (n = 40, France (n = 51 and performed association study comparing observed variant distribution with this obtained in a genetically similar Czech healthy control population (n = 96 described in our earlier data report. A highly significant association for a promoter variant (rs35705950 of mucin encoding MUC5B gene was observed in all IPF populations, individually and combined [OR (95% CI; p-value as 5.23 (8.94-3.06; 1.80x10-11. Another non-coding variant, rs7934606 in MUC2 was significant among German patients [2.85 (5.05-1.60; 4.03x10-4] and combined European IPF cases [2.18 (3.16-1.50; 3.73x10-5]. The network analysis for these variants indicated gene-gene and gene-phenotype interactions in IPF and lung biology. With replication of MUC5B rs35705950 previously reported in U.S. populations of European descent and indicating other plausible polymorphic variants relevant for IPF, we provide additional reference information for future extended functional and population studies aimed, ideally with inclusion of clinical parameters, at identification of IPF genetic markers.

PPPs IN THE EUROPEAN UNION. GUIDELINES FOR ROMANIA?

Directory of Open Access Journals (Sweden)

Ciprian GORIŢĂ

2012-06-01

Full Text Available Several starting points could be used in an analysis on the possible routes for developing Public-Private Partnership1 (henceforth PPP projects in Romania, regarded as an alternative financing mechanism for public infrastructure. This paper follows a “classical” approach, with a focus on the pros and cons of the Public-Private Partnership concept, legal forms met in the European acquis, the Eurostat view on such projects in terms of the statistical classification of assets, financing and policy directions in the European Union and lessons learnt for practitioners in Romania, while taking into account the recent developments of the PPP market in the European Union

Inter-ethnic differences in valve morphology, valvular dysfunction, and aortopathy between Asian and European patients with bicuspid aortic valve.

Science.gov (United States)

Kong, William K F; Regeer, Madelien V; Poh, Kian K; Yip, James W; van Rosendael, Philippe J; Yeo, Tiong C; Tay, Edgar; Kamperidis, Vasileios; van der Velde, Enno T; Mertens, Bart; Ajmone Marsan, Nina; Delgado, Victoria; Bax, Jeroen J

2018-04-14

Transcatheter aortic valve replacement (TAVR) has been shown safe and feasible in patients with bicuspid aortic valve (BAV) morphology. Evaluation of inter-ethnic differences in valve morphology and function and aortic root dimensions in patients with BAV is important for the worldwide spread of this therapy in this subgroup of patients. Comparisons between large European and Asian cohorts of patients with BAV have not been performed, and potential differences between populations may have important implications for TAVR. The present study evaluated the differences in valve morphology and function and aortic root dimensions between two large cohorts of European and Asian patients with BAV. Aortic valve morphology was defined on transthoracic echocardiography according to the number of commissures and raphe: type 0 = no raphe and two commissures, type 1 = one raphe and two commissures, type 2 = two raphes and one commissure. Aortic stenosis and regurgitation were graded according to current recommendations. For this study, aortic root dimensions were manually measured on transthoracic echocardiograms at the level of the aortic annulus, sinus of Valsalva (SOV), sinotubular junction (STJ), and ascending aorta (AA). Of 1427 patients with BAV (45.2 ± 18.1 years, 71.9% men), 794 (55.6%) were Europeans and 633 (44.4%) were Asians. The groups were comparable in age and proportion of male sex. Asians had higher prevalence of type 1 BAV with raphe between right and non-coronary cusps than Europeans (19.7% vs. 13.6%, respectively; P < 0.001), whereas the Europeans had higher prevalence of type 0 BAV (two commissures, no raphe) than Asians (14.5% vs. 6.8%, respectively; P < 0.001). The prevalence of moderate and severe aortic regurgitation was higher in Europeans than Asians (44.2% vs. 26.8%, respectively; P < 0.001) whereas there were no differences in BAV with normal function or aortic stenosis. After adjusting for demographics, comorbidities

European Languages: Instruments and Symbols

Directory of Open Access Journals (Sweden)

Martina Ožbot

2008-07-01

Further, the role of Latin as the single most important European language over the centuries and as a unifying feature of European culture is discussed. Parallels are drawn between Latin as the historical European lingua franca on the one hand and English as the modern language of international communication on the other: the importance of both languages started growing after substantial territorial expansion of their speakers and it was especially the political and economic power associated to these languages that played a significant role in their diffusion and long-term influence. Taking into consideration the instrumental as well as the symbolic function of languages, the question about the relationship between English and other European languages in today’s Europe is dealt with; it is suggested that the European languages are in principle not endangered as a result of the spread of English, with the exception of those instances in which English has been taking over the functions they have traditionally performed as national or community languages. It is emphasized that the future of Europe lies in the promotion of biand multilingualism, which have, in actual fact, been present on this continent throughout its history, and which in the cases of some European languages (e.g. Catalan, Basque, Irish, etc. have been successfully enhanced over the past decades.

Sequential SPECT/CT imaging starting with stress SPECT in patients with left bundle branch block suspected for coronary artery disease

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Engbers, Elsemiek M.; Mouden, Mohamed [Isala, Department of Cardiology, Zwolle (Netherlands); Isala, Department of Nuclear Medicine, Zwolle (Netherlands); Timmer, Jorik R.; Ottervanger, Jan Paul [Isala, Department of Cardiology, Zwolle (Netherlands); Knollema, Siert; Jager, Pieter L. [Isala, Department of Nuclear Medicine, Zwolle (Netherlands)

2017-01-15

To investigate the impact of left bundle branch block (LBBB) on sequential single photon emission computed tomography (SPECT)/ CT imaging starting with stress-first SPECT. Consecutive symptomatic low- to intermediate-risk patients without a history of coronary artery disease (CAD) referred for SPECT/CT were included from an observational registry. If stress SPECT was abnormal, additional rest SPECT and, if feasible, coronary CT angiography (CCTA) were acquired. Of the 5,018 patients, 218 (4.3 %) demonstrated LBBB. Patients with LBBB were slightly older than patients without LBBB (65±12 vs. 61±11 years, p<0.001). Stress SPECT was more frequently abnormal in patients with LBBB (82 % vs. 46 %, p<0.001). After reviewing stress and rest images, SPECT was normal in 43 % of the patients with LBBB, compared to 77 % of the patients without LBBB (p<0.001). Sixty-four of the 124 patients with LBBB and abnormal stress-rest SPECT underwent CCTA (52 %), which could exclude obstructive CAD in 46 of the patients (72 %). Sequential SPECT/CT imaging starting with stress SPECT is not the optimal imaging protocol in patients with LBBB, as the majority of these patients have potentially false-positive stress SPECT. First-line testing using CCTA may be more appropriate in low- to intermediate-risk patients with LBBB. (orig.)

Red Flags for Maltese Adults with Congenital Heart Disease: Poorer Dental Care and Less Sports Participation Compared to Other European Patients-An APPROACH-IS Substudy.

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Caruana, Maryanne; Apers, Silke; Kovacs, Adrienne H; Luyckx, Koen; Thomet, Corina; Budts, Werner; Sluman, Maayke; Eriksen, Katrine; Dellborg, Mikael; Berghammer, Malin; Johansson, Bengt; Soufi, Alexandra; Callus, Edward; Moons, Philip; Grech, Victor

2017-06-01

Studies in recent years have explored lifestyle habits and health-risk behaviours in adult congenital heart disease (ACHD) patients when compared to controls. The aim of this study was to investigate differences in lifestyle habits between Maltese and other European ACHD patients. Data on alcohol consumption, cigarette smoking, substance misuse, dental care and physical activity collected in 2013-2015 during "Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study" (APPROACH-IS) were analysed. Responses from 119 Maltese participants were compared to those of 1616 participants from Belgium, France, Italy, Norway, Sweden, Switzerland and the Netherlands. Significantly fewer Maltese patients with simple (Maltese 84.1% vs. European 97.5%, p < 0.001) and moderately complex CHD (Maltese 83.6% vs. European 97.4%, p < 0.001) brushed their teeth daily. Only 67.2% of Maltese with moderately complex disease had dental reviews in the previous year compared to 80.3% of Europeans (p = 0.02). Maltese patients with simple (Maltese 31.8% vs. European 56.1%, p = 0.002) and moderately complex lesions (Maltese 30.0% vs. European 59.2%, p < 0.001) performed less regular sport activities. Comparison by country showed Maltese patients to have significantly poorer tooth brushing and sports participation than patients from any other participating country. Alcohol consumption, cigarette smoking and substance misuse were not significantly different. This study highlights lifestyle aspects that Maltese ACHD patients need to improve on, which might not be evident upon comparing patients to non-CHD controls. These findings should also caution researchers against considering behaviours among patients in one country as necessarily representative of patients on the larger scale.

Impact of a Two-step Emergency Department Triage Model with START, then CTAS, on Patient Flow During a Simulated Mass-casualty Incident.

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Lee, James S; Franc, Jeffrey M

2015-08-01

A high influx of patients during a mass-casualty incident (MCI) may disrupt patient flow in an already overcrowded emergency department (ED) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step ED triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on patient flow during a MCI simulation exercise. Hypothesis/Problem It was hypothesized that there would be no difference in time intervals nor patient volumes at each patient-flow milestone. Physicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. Patient-flow milestones including time intervals and patient volumes from ED arrival to triage, ED arrival to bed assignment, ED arrival to physician assessment, and ED arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes. There were no significant differences in the time interval from ED arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), ED arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), ED arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and ED arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of patients to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar

Observations on European Education and Educational Research: The "European Educational Research Journal" at Work, 2002-2014

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Lindblad, Sverker

2014-01-01

This is a review of the "European Educational Research Journal" ("EERJ") since the start in 2002 and up to 2014. Three questions were put forward: what are the ambitions with the journal, how has the journal developed over time, and what are its possible futures? The review is based on minutes and emails from the late 1990s up…

Association of blood pressure with decline in renal function and time until the start of renal replacement therapy in pre-dialysis patients: a cohort study

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Sijpkens Yvo WJ

2011-08-01

Full Text Available Abstract Background To investigate whether high blood pressure accelerates renal function decline in patients with advanced chronic kidney disease (CKD, we studied the association of systolic (SBP and diastolic blood pressure (DBP with decline in renal function and time until the start of renal replacement therapy (RRT in patients with CKD stages IV-V on pre-dialysis care. Methods In the PREPARE-1 cohort 547 incident pre-dialysis patients, referred as part of the usual care to outpatient clinics of eight Dutch hospitals, were included between 1999 and 2001 and followed until the start of RRT, mortality, or end of follow-up (January 1st 2008. Main outcomes were rate of decline in renal function, estimated as the slope of available eGFR measurements, and time until the start of RRT. Results A total of 508 patients, 57% men and median (IQR age of 63 (50-73 years, were available for analyses. Mean (SD decline in renal function was 0.35 (0.75 ml/min/1.73 m2/month. Every 10 mmHg increase in SBP or DBP resulted in an accelerated decline in renal function (adjusted additional decline 0.04 (0.02;0.07 and 0.05 (0.00;0.11 ml/min/1.73 m2/month respectively and an earlier start of RRT (adjusted HR 1.09 (1.04;1.14 and 1.16 (1.05;1.28 respectively. Furthermore, patients with SBP and DBP above the BP target goal of 2/month and an earlier start of RRT (adjusted HR 2.08 (1.25;3.44, compared to patients who achieved the target goal (11%. Comparing the decline in renal function and risk of starting RRT between patients with only SBP above the target (≥ 130 mmHg and patients with both SBP and DBP below the target (2/month and adjusted HR 2.24 (1.26;3.97. Therefore, it seems that especially having SBP above the target is harmful. Conclusions In pre-dialysis patients with CKD stages IV-V, having blood pressure (especially SBP above the target goal for CKD patients (

Globalization and Europeanization. A Projection on a European Model of Public Administration

Directory of Open Access Journals (Sweden)

Ani Matei

2008-04-01

Full Text Available The specialized studies and literature present moreover and insistently the connection between globalization and Europeanization, more precisely between globalization and a European model of integration, whose features aim to set up a global-type European society. The development of the European model of integration starts with economic elements, it reveals nowadays the Economic and Monetary Union and in perspective it will be structured within a sui generis system of transnational governance. The values of the European model of integration become fundamental values of a social process, with powerful economic and political determinations, aiming the multi-causal interference between individual, community and European construction. This process, remarked increasingly in the specialized literature, being assigned with the name of Europeanization, has got original, functional features in the spectrum of significations of the globalization paradigm. As essential global-type formula, within Europeanization, we shall find models with economic, political or social finality, integrating also a model of administration among the latter ones. When we say administration, we refer to its up dated and adequate contents to the new European developments. This assertion derives from a less economic modality to conceptualize the relationship between globalization and Europeanization, presenting Europeanization more as a political adaptation to globalization and even a political expression of globalization. In this context, the development of a system for European governance on several levels (local, regional, national, intergovernmental and supranational suggests its evolution towards globalization. In fact, the literature specific for Europeanization asserts the fact that the European model has also features with integrative nature related to the supranational and trans-governmental dimensions, as well as features with normative nature in view of harmonization

European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017).

Science.gov (United States)

Hellings, Peter W; Borrelli, David; Pietikainen, Sirpa; Agache, Ioana; Akdis, Cezmi; Bachert, Claus; Bewick, Michael; Botjes, Erna; Constantinidis, Jannis; Fokkens, Wytske; Haahtela, Tari; Hopkins, Claire; Illario, Maddalena; Joos, Guy; Lund, Valerie; Muraro, Antonella; Pugin, Benoit; Seys, Sven; Somekh, David; Stjärne, Pär; Valiulis, Arunas; Valovirta, Erkka; Bousquet, Jean

2017-01-01

On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.

Mortality in primary angioplasty patients starting antiplatelet therapy with prehospital prasugrel or clopidogrel

DEFF Research Database (Denmark)

Goldstein, Patrick; Grieco, Niccolò; Ince, Hüseyin

2016-01-01

hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV) mortality. METHODS AND RESULTS: MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI) from 25 hospitals in nine countries, all of which had an established practice...... of prehospital start of dual antiplatelet therapy in place. The key outcome was CV death at 1 year. Among 2,036 patients followed-up through 1 year, 49 died (2.4%), 10 during the initial hospitalization and 39 within 1 year after hospital discharge. The primary analysis was based on the P2Y12-inhibitor, used...... from prehospital loading dose through hospital discharge. Prasugrel (n=824) was more commonly used than clopidogrel (n=425). The observed 1-year rates for CV death were 0.5% with prasugrel and 2.6% with clopidogrel. After adjustment for differences in baseline characteristics, treatment with prasugrel...

Comparison of long-term prognosis of patients with AIDS treated and not treated with zidovudine. AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Phillips, A N; Pedersen, C

1994-01-01

zidovudine, the death rate was approximately constant for the first 5 years after AIDS diagnosis. For patients treated with zidovudine, the death rate within the first year since starting zidovudine was markedly lower than for untreated patients who had developed AIDS at the same time (relative rate, 0......OBJECTIVE--To determine the association between elapsed time since starting zidovudine and survival in patients with acquired immunodeficiency syndrome (AIDS). DESIGN--Inception cohort and observational study of patients treated and not treated with zidovudine. SETTING--Fifty-one centers in 17...... European countries. PATIENTS--A total of 4484 patients diagnosed as having AIDS from 1979 to 1989 who survived their initial AIDS-defining event and who had not started zidovudine before AIDS diagnosis. MAIN OUTCOME MEASURES--Use of zidovudine and mortality. RESULTS--Among patients who did not receive...

Introducing a European Partnership. First issue of 'European Nuclear Features'. A joint publication of atw, Nuclear Espana, Revue Generale Nucleare (2004)

International Nuclear Information System (INIS)

2004-01-01

'European Nuclear Features' is a joint publication of the three specialized technical journals, Nuclear Espana (Spain), Revue Generale Nucleaire (France), and atw - International Journal for Nuclear Power (Germany), planned for six issues annually. ENF is to further greatly the international European exchange of information and news about energy and nuclear power. News items, comments, and scientific and technical contributions will cover important aspects of the field. The first issue of ENF contains contributions about these topics, among others: - European Nuclear Society and Foratom: Strengthening the Nuclear Network. - Report: EPR - the European Pressurized Water Reactor. - Finland: Starting Construction of the Fifth Nuclear Power Plant. - Czech Republic: Nuclear Power Report for 2003/2004. - The Decommissioning Project of the Bohunice-1 and -2 Units. - FRM-II: TUM Research Neutron Source Generates Its First Neutrons. (orig.)

Balanced or biased? Interest groups and legislative lobbying in the European news media

NARCIS (Netherlands)

De Bruycker, I.; Beyers, J.

2015-01-01

This article examines the coverage of legislative lobbying in European news media. The starting point thereby is that lobbying in the crowded European Union (EU)-level interest community is not only a struggle for direct access to policymakers, but that in order to realize policy goals many interest

The European Medicines Agency Review of Panobinostat (Farydak) for the Treatment of Adult Patients with Relapsed and/or Refractory Multiple Myeloma.

Science.gov (United States)

Tzogani, Kyriaki; van Hennik, Paula; Walsh, Ita; De Graeff, Pieter; Folin, Annika; Sjöberg, Jan; Salmonson, Tomas; Bergh, Jonas; Laane, Edward; Ludwig, Heinz; Gisselbrecht, Christian; Pignatti, Francesco

2017-11-30

On August 28, 2015, a marketing authorization valid through the European Union was issued for panobinostat, in combination with bortezomib and dexamethasone, for the treatment of adult patients with relapsed and/or refractory multiple myeloma who have received at least two prior regimens including bortezomib and an immunomodulatory agent (IMiD).Panobinostat is an orally available histone deacetylase (HDAC) inhibitor that inhibits the enzymatic activity of HDAC proteins at nanomolar concentrations. HDAC proteins catalyze the removal of acetyl groups from the lysine residues of histones and some nonhistone proteins. Inhibition of HDAC activity results in increased acetylation of histone proteins, an epigenetic alteration that results in a relaxing of chromatin, leading to transcriptional activation. The recommended starting dose of panobinostat is 20 mg, taken orally in a cyclical manner for up to 48 weeks.The use of panobinostat in combination with bortezomib and dexamethasone was studied in a randomized, double-blind, placebo-controlled, multicenter phase III study (PANORAMA I) in 768 patients with relapsed or relapsed and refractory multiple myeloma who had received one to three prior lines of therapies. In the subgroup of patients who have received at least two prior regimens including bortezomib and an IMiD, there was a difference of 7.8 months in the progression-free survival in favor of the experimental arm (12.5 months for panobinostat + bortezomib + dexamethasone vs. 4.7 months for placebo + bortezomib + dexamethasone; hazard ratio = 0.47, 95% confidence interal 0.31-0.72; log-rank p value = .0003). The incidence of grade 3-4 adverse events suspected to be related to study drug was 76.9% vs. 51.2%, for the panobinostat and the placebo group, respectively. The most common side effects (grade 3-4) associated with panobinostat included diarrhea (18.9%), fatigue (14.7%), nausea (4.5%), vomiting (5.5%), thrombocytopenia (43.6%), anemia (7

European Master's Program in Gerontology (EuMaG): Goals, Curriculum, and Students

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Aartsen, Marja

2011-01-01

The European Master's Program in Gerontology (EuMaG) started in September 2003 with support from the European Commission. The EuMaG is a modular, 2-year, part-time international training program about the aging process and its societal implications. The multidisciplinary curriculum comprises four domains of gerontology (i.e., social gerontology,…

European guidelines for workplace drug testing in urine.

Science.gov (United States)

Taskinen, Sanna; Beck, Olof; Bosch, Tessa; Brcak, Michaela; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Weinmann, Wolfgang

2017-06-01

These European Guidelines for Workplace Drug Testing in Urine have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The first version of these urine guidelines was published in 2002. Since then, the guidelines have been followed by many laboratories in different European countries and their role has been essential particularly in countries lacking legislation for workplace drug testing. In 2014, the EWDTS started a guidelines updating project and published a new version of the urine guidelines in 2015. Here we represent this updated version of the urine guidelines. The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

European Union definitely introduces common taxes on energy

International Nuclear Information System (INIS)

Schoenweisner, R.

2003-01-01

In this paper taxes of the European Union on energy are reviewed. European Union Ministers of environment Council definitely ratified new common system of minimal energy taxes in last week. Council introduces par excellence minimal all-European size of an electricity, coal and natural gas consumption tax. New directive according to European Commission will improve operation of internal market and eliminate deformation of competitive environment among individual members as well as among mineral oils and the other energy sources. Slovak Republic taxes all motor fuel types by higher charge as is minimal level demanded by EU according to new directive after rising of consumable tax from mineral oils in August 2003. According to Minister of Finances Slovak Republic demanded European Union for a temporary 10-year period for utilizing electricity, coal, coke, and natural gas consumption tax. According to Ministry, Utilizing new taxes and rising of tax load is not in interest of started tax reform in Slovak Republic

European Institutional Developments and Evolutions Post‑Lisbon Treaty

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Cristian Sorin Dumitrescu

2014-11-01

Full Text Available The current article aims at analysing the main difficulties the European institutions were confronted to and identifying the axes of urgent reforms of the European construction, which are claimed to be applied, immediately, after the recent parliamentary elections from 25 of May together with the installation of the new decision teams in Brussels. While the first part of the article examine the action of the various European institutions within the new constitutional architecture, the second part will cover some axes needed which could be followed by the Union starting with the new term. In the context of the economic and financial crisis, the first European institutional cycle under the terms of the Lisbon Treaty –2009-2014, became an important challenge for the application of the provisions concerning the functioning of the European institutions. An objective assessment of the ways regarding the practical implementation of the Treaty must take into consideration the negative influence of the economic crisis upon the decisions assumed by the high national and European responsibles.

Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study.

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Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B; Howard, Andrea A

2017-01-01

mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.

The Italian START-Register on Anticoagulation with Focus on Atrial Fibrillation

Science.gov (United States)

2015-01-01

START-Register – Survey on anTicoagulated pAtients RegisTer – is an independent, inception-cohort, observational, collaborative database aimed at recording prospectively the clinical history of adult patients starting anticoagulant treatment for any reason and using whatever drug. In this article we present the START-Register and give cross section baseline data focusing on non valvular atrial fibrillation (NVAF). Participants are asked to insert prospectively consecutive patients recorded as electronic file on the web-site of the registry. Required data are: demographic and clinical characteristics of patients, associated risk factors for stroke and bleeding, laboratory routine data, clinical indication for treatment, expected therapeutic range (in cases of treatment with vitamin K antagonists -VKAs). The follow-up is carried out to record: quality of treatment (for patients on VKAs), bleeding complications, thrombotic events, and the onset of any type of associated disease. To date 5252 patients have been enrolled; 97.6% were on VKAs because direct oral anticoagulants (DOAC) have been available in Italy only recently. The median age was 74 years [interquartile range (IQR) 64-80]; males 53.7%. This analysis is focused on the 3209 (61.1%) NVAF patients. Mean CHADS2 score was 2.1±1.1, CHADSVASc score was 3.1±1.3;median age was 76 years (IQR 70-81); 168 patients (5.3%) had severe renal failure [Creatinine clearance (CrCl) START-Register data shows that two-third of patients who started chronic anticoagulant treatment had NVAF, one-third of them was > 80 years with high prevalence of renal failure. PMID:26001109

Patients' perceptions of information and education for renal replacement therapy: an independent survey by the European Kidney Patients' Federation on information and support on renal replacement therapy

NARCIS (Netherlands)

van Biesen, Wim; van der Veer, Sabine N.; Murphey, Mark; Loblova, Olga; Davies, Simon

2014-01-01

Selection of an appropriate renal replacement modality is of utmost importance for patients with end stage renal disease. Previous studies showed provision of information to and free modality choice by patients to be suboptimal. Therefore, the European Kidney Patients' Federation (CEAPIR) explored

Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries

DEFF Research Database (Denmark)

Geelhoed-Duijvestijn, Petronella H; Pedersen-Bjergaard, Ulrik; Weitgasser, Raimund

2013-01-01

the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing. Methods: Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics...

Patient-centeredness of integrated care programs for people with multimorbidity: results from the European ICARE4EU project.

NARCIS (Netherlands)

Heide, I. van der; Snoeijs, S.; Quattrini, S.; Struckmann, V.; Hujala, A.; Schellevis, F.; Rijken, M.

2018-01-01

Introduction: This paper aims to support the implementation of patient-centered care for people with multimorbidity in Europe, by providing insight into ways in which patient-centeredness is currently shaped in integrated care programs for people with multimorbidity in European countries. Methods:

PEP725 Pan European Phenological Database

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Koch, E.; Adler, S.; Lipa, W.; Ungersböck, M.; Zach-Hermann, S.

2010-09-01

Europe is in the fortunate situation that it has a long tradition in phenological networking: the history of collecting phenological data and using them in climatology has its starting point in 1751 when Carl von Linné outlined in his work Philosophia Botanica methods for compiling annual plant calendars of leaf opening, flowering, fruiting and leaf fall together with climatological observations "so as to show how areas differ". Recently in most European countries, phenological observations have been carried out routinely for more than 50 years by different governmental and non governmental organisations and following different observation guidelines, the data stored at different places in different formats. This has been really hampering pan European studies as one has to address many network operators to get access to the data before one can start to bring them in a uniform style. From 2004 to 2009 the COST-action 725 established a European wide data set of phenological observations. But the deliverables of this COST action was not only the common phenological database and common observation guidelines - COST725 helped to trigger a revival of some old networks and to establish new ones as for instance in Sweden. At the end of 2009 the COST action the database comprised about 8 million data in total from 15 European countries plus the data from the International Phenological Gardens IPG. In January 2010 PEP725 began its work as follow up project with funding from EUMETNET the network of European meteorological services and of ZAMG the Austrian national meteorological service. PEP725 not only will take over the part of maintaining, updating the COST725 database, but also to bring in phenological data from the time before 1951, developing better quality checking procedures and ensuring an open access to the database. An attractive webpage will make phenology and climate impacts on vegetation more visible in the public enabling a monitoring of vegetation development.

Health management and patients who lack capacity: forms of guardianship in European health policy.

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Bonsignore, Alessandro; Smith, Anna; De Stefano, Francesco; Molinelli, Andrea

2014-02-01

The focus of healthcare debate has in recent years shifted from doctors and healthcare professionals in general to patients and the principle of patient self-determination. Patient competence therefore plays an increasingly central role in the legal framework of many Europeans countries. Consequently, healthcare policy has to address the possible repercussions of a non-systematic approach to cases of patient incapacity. The diverse nature of the experiences of the mentally or physically disadvantaged clearly raises problems for the healthcare professional. In this setting, we examine Italy's Law no. 6/2004 from a comparative perspective, in particular analysing legislation in the same area from Spain, France, Great Britain and the Netherlands. Copyright © 2013. Published by Elsevier Ireland Ltd.

Depressed mood, usual activity level, and continued employment after starting dialysis.

Science.gov (United States)

Kutner, Nancy G; Zhang, Rebecca; Huang, Yijian; Johansen, Kirsten L

2010-11-01

When patients start dialysis, their employment rate declines and disability benefits are an option. With patient sociodemographic and clinical characteristics including disability income status controlled, we investigated the significance of depressed mood and usual activity level as predictors of patients' continued employment after dialysis start. Incident patients from 296 randomly selected dialysis clinics were surveyed in the Comprehensive Dialysis Study (CDS). Participants provided information about employment status, disability income status, education, depressive symptoms measured by the Patient Health Questionnaire-2 (PHQ-2), and usual activity level/energy expenditure measured by the Human Activity Profile. Age, gender, race, insurance, diabetes, inability to ambulate or transfer, chronic obstructive pulmonary disease, cardiovascular conditions, and hemoglobin and serum albumin values at treatment start were obtained from US Renal Data System files. Dialysis modality was defined at time of interview. Among 585 CDS participants who worked in the previous year, 191 (32.6%) continued working after dialysis start. On the basis of the PHQ-2 cutoff score ≥3, 12.1% of patients who remained employed had possible or probable depression, compared with 32.8% of patients who were no longer employed. In adjusted analyses, higher Human Activity Profile scores were associated with increased likelihood of continued employment, and there was a borderline association between lower PHQ-2 scores and continued employment. Screening and management of depressive symptoms and support for increased activity level may facilitate patients' opportunity for continued employment after dialysis start, along with generally improving their overall quality of life.

Economic evaluation of the randomized European Achalasia trial comparing pneumodilation with Laparoscopic Heller myotomy.

Science.gov (United States)

Moonen, A; Busch, O; Costantini, M; Finotti, E; Tack, J; Salvador, R; Boeckxstaens, G; Zaninotto, G

2017-11-01

A recent multicenter randomized trial in achalasia patients has shown that pneumatic dilation resulted in equivalent relief of symptoms compared to laparoscopic Heller myotomy. Additionally, the cost of each treatment should be also taken in consideration. Therefore, the aim of the present study was to perform an economic analysis of the European achalasia trial. Patients with newly diagnosed achalasia were enrolled from to 2003 to 2008 in 14 centers in five European countries and were randomly assigned to either pneumatic dilation (PD) or laparoscopic Heller (LHM). The economic analysis was performed in the three centers in three different countries where most patients were enrolled (Amsterdam [NL], Leuven, [B] and Padova [I]) and then applied to all patients included in the study. The total raw costs of the two treatments per patient include the initial costs, the costs of complications, and the costs of retreatments. Two hundred and one patients, 107 (57 males and 50 females, mean age 46 CI: 43-49 years) were randomized to LHM and 94 (59 males and 34 females, mean age 46 CI 43-50 years) to PD. The total cost of PD per patient was quite comparable in the three different centers; €3397 in Padova, €3259 in Amsterdam and €3792 in Leuven. For LHM, the total costs per patient were highest in Amsterdam: €4488 in Padova, €6720 in Amsterdam, and €5856 in Leuven. In conclusion, the strategy of treating achalasia starting with PD appears the most economic approach, independent of the health system. © 2017 John Wiley & Sons Ltd.

Coronary artery bypass grafts and diagnosis related groups: patient classification and hospital reimbursement in 10 European countries

Science.gov (United States)

2014-01-01

Background The prospective reimbursement of hospitals through the grouping of patients into a finite number of categories (Diagnosis Related Groups, DRGs), is common to many European countries. However, the specific categories used vary greatly across countries, using different characteristics to define group boundaries and thus those characteristics which result in different payments for treatment. In order to assist in the construction and modification of national DRG systems, this study analyses the DRG systems of 10 European countries. Aims To compare the characteristics used to categorise patients receiving a coronary artery bypass graft (CABG) surgery into DRGs. Further, to compare the structure into which DRGs are placed and the relative price paid for patients across Europe. Method Patients with a procedure of CABG surgery are analysed from Austria, England, Estonia, Finland, France, Germany, Ireland, Poland, Spain and Sweden. Diagrammatic algorithms of DRG structures are presented for each country. The price in Euros of seven typical case vignettes, each made up of a set of a hypothetical patient’s characteristics, is also analysed for each country. In order to enable comparisons across countries the simplest case (index vignette) is taken as baseline and relative price levels are calculated for the other six vignettes, each representing patients with different combinations of procedures and comorbidities. Results European DRG payment structures for CABG surgery vary in terms of the number of different DRGs used and the types of distinctions which define patient categorisation. Based on the payments given to hospitals in different countries, the most resource intensive patient, relative to the index vignette, ranges in magnitude from 1.37 in Poland to 2.82 in Ireland. There is also considerable variation in how much different systems pay for particular circumstances, such as the occurrence of catheterisation or presence of comorbidity. Conclusion Past

European Climate Change Policy Beyond 2012

International Nuclear Information System (INIS)

Ulreich, S.

2009-01-01

Europe sees itself on the forefront to combat climate change. Consequently, the European Union has adopted in 2003 a Directive on Emissions Trading and since then, focuses more and more on effective methods to reduce greenhouse gas emissions. So far, there is little knowledge about the further development of Climate Change Policy in Europe after 2012. The EU has already started a review process to define the new legislation starting in 2013. Furthermore, negotiations take place to develop a successor of the Kyoto protocol. The European energy sector can deliver valuable input to the discussion about the coming climate goals and how to achieve them, by addressing the importance of new climate-friendly technologies. Furthermore, the impact of climate change goals on the current investment decisions in the energy sector has to be stressed. Europe will certainly not solve the climate problem on its own, but can help to deliver abatement technologies and to prove, that climate change can be reconciled with economic growth - provided a long-term framework is established that is in line with other goals like security of supply and affordable energy.(author).

Continuing Medical Education for European General Practitioners in Doctor-Patient Relationship Skills and Psychosocial Issues.

Science.gov (United States)

Barker, L. Randol

1998-01-01

Most of the 23 European providers of continuing medical education (CME) surveyed reported programming on the doctor-patient relationship and psychosocial issues. Visits to programs in France, the Netherlands, and Spain identified the formats used most often in small group instruction, intensive individual learning, and national-level CME. (SK)

Persistence of pharmacological treatment into adulthood, in UK primary care, for ADHD patients who started treatment in childhood or adolescence

Directory of Open Access Journals (Sweden)

McCarthy Suzanne

2012-12-01

Full Text Available Abstract Background ADHD guidelines in the UK suggest that children and adults who respond to pharmacological treatment should continue for as long as remains clinically effective, subject to regular review. To what extent patients persist with treatment from childhood and adolescence into adulthood is not clear. This study aims to describe, in UK primary care, the persistence of pharmacological treatment for patients with ADHD who started treatment aged 6–17 years and to estimate the percentage of patients who continued treatment from childhood and adolescence into adulthood. Methods The Health Improvement Network (THIN database was used to identify patients with ADHD who received their first prescription for methylphenidate/ dexamfetamine/atomoxetine, aged 6–17 years. Patients were monitored until their ‘censored date’ (the earliest of the following dates: date the last prescription coded in the database ended, end of the study period (31st December 2008, date at which they transferred out of their practice, date of death, the last date the practice contributed data to the database. Persistence of treatment into adulthood was estimated using Kaplan Meier analysis. Results 610 patients had follow-up data into adulthood. 213 patients (93.4% male started treatment between 6–12 years; median treatment duration 5.9 years. 131 (61.5% stopped before 18 years, 82 (38.5% were still on treatment age ≥18 years. 397 patients (86.4% male started treatment between 13–17 years; median treatment duration was 1.6 years. 227 (57.2% stopped before 18 years, 170 (42.8% were still on treatment age ≥18 years. The number of females in both age categories was too small to formally test for differences between genders in persistence of treatment. Conclusion Persistence of treatment into adulthood is lower (~40% compared with published rates of persistence of the condition (~65% when symptomatic definition of remission used. Due to the limited number of

A European Project SysPAQ

OpenAIRE

Muller , Birgit; Dahms , Arne; Muller , Dirk; Knudsen , Henrik; Afshari , Alireza; Wargocki , Pawel; Olesen , Bjarne; Berglund , Brigitta; Ramalho , Olivier; Goschnick , Joachim; Jann , Oliver; Horn , Wolfgang; Nesa , Daniel; Chanier , Eric; Ruponen , Mika

2007-01-01

International audience; The European research project Innovative Sensor System for Measuring Perceived Air Quality and Brand Specific Odours (SysPAQ) is started under the VIth framework programme under the work programme "New and Emerging Science and Technology" (NEST PATHFINDER "Measuring the Impossible"). The Kick-of of the project was on the first of September 2006. Ten partners (3 Companies, 3 Universities, 4 research Institutes) from 5 countries are involved. The main goal of this projec...

Application of the STOPP/START criteria to a medical record database.

Science.gov (United States)

Nauta, Katinka J; Groenhof, Feikje; Schuling, Jan; Hugtenburg, Jacqueline G; van Hout, Hein P J; Haaijer-Ruskamp, Flora M; Denig, Petra

2017-10-01

The STOPP/START criteria are increasingly used to assess prescribing quality in elderly patients at practice level. Our aim was to test computerized algorithms for applying these criteria to a medical record database. STOPP/START criteria-based computerized algorithms were defined using Anatomical-Therapeutic-Chemical (ATC) codes for medication and International Classification of Primary Care (ICPC) codes for diagnoses. The algorithms were applied to a Dutch primary care database, including patients aged ≥65 years using ≥5 chronic drugs. We tested for associations with patient characteristics that have previously shown a relationship with the original STOPP/START criteria, using multivariate logistic regression models. Included were 1187 patients with a median age of 75 years. In total, 39 of the 62 STOPP and 18 of the 26 START criteria could be converted to a computerized algorithm. The main reasons for inapplicability were lack of information on the severity of a condition and insufficient covering of ICPC-codes. We confirmed a positive association between the occurrence of both the STOPP and the START criteria and the number of chronic drugs (adjusted OR ranging from 1.37, 95% CI 1.04-1.82 to 3.19, 95% CI 2.33-4.36) as well as the patient's age (adjusted OR for STOPP 1.30, 95% CI 1.01-1.67; for START 1.73, 95% CI 1.35-2.21), and also between female gender and the occurrence of STOPP criteria (adjusted OR 1.41, 95% CI 1.09-1.82). Sixty-five percent of the STOPP/START criteria could be applied with computerized algorithms to a medical record database with ATC-coded medication and ICPC-coded diagnoses. Copyright © 2017 John Wiley & Sons, Ltd.

European Symposium on Precision Medicine in Allergy and Airways Diseases: Report of the European Union Parliament Symposium (October 14, 2015).

Science.gov (United States)

Muraro, A; Fokkens, W J; Pietikainen, S; Borrelli, D; Agache, I; Bousquet, J; Costigliola, V; Joos, G; Lund, V J; Poulsen, L K; Price, D; Rolland, C; Zuberbier, T; Hellings, P W

2016-05-01

The European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS), and the European Medical Association (EMA) organized, on October 14, 2015, a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP David Borrelli, and with active participation of the EU Commissioner for Health and Food Safety Vytenis Andriukaitis, MEP Sirpa Pietikainen, Chair of the European Parliament Interest Group on Allergy and Asthma, the European Respiratory Society (ERS), the European Federations of Allergy and Airways Diseases Patients Associations (EFA), the Global Allergy and Asthma European Network (Ga2len), Allergic Rhinitis and Its Impact on Asthma (ARIA), and the Respiratory Effectiveness Group (REG). The socioeconomic impact of allergies and chronic airways diseases cannot be underestimated, as they represent the most frequently diagnosed chronic noncommunicable diseases in the EU; 30% of the total European population is suffering from allergies and asthma, and more than half are deprived from adequate diagnosis and treatment. Precision medicine represents a novel approach, embracing four key features: personalized care based on molecular, immunologic, and functional endotyping of the disease, with participation of the patient in the decision-making process of therapeutic actions, and considering predictive and preventive aspects of the treatment. Implementation of precision medicine into clinical practice may help to achieve the arrest of the epidemic of allergies and chronic airways diseases. Participants underscored the need for optimal patient care in Europe, supporting joint action plans for disease prevention, patient empowerment, and cost-effective treatment strategies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Does pregnancy change the disease course? A study in a European cohort of patients with inflammatory bowel disease

DEFF Research Database (Denmark)

Riis, L; Vind, Ida; Politi, P

2006-01-01

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) often affects patients in their fertile age. The aim of this study was to describe pregnancy outcome in a European cohort of IBD patients. As data are limited regarding the effect of pregnancy on disease course, our second objective was to inv...

HARMONISATION OF EUROPEAN CONTRACT LAW: SLOWLY BUT SURELY?

Directory of Open Access Journals (Sweden)

GEMA TOMÁS

2013-05-01

Full Text Available This paper deals with the harmonisation of European Contract Law from a gradual point of view. The main objective is to show the different academic and official steps carried out in this field. The so called Commission on European Contract Law under the leadership of Professor Ole Lando was the starting point in 1982. Some international research teams set up by European scholars and lawyers have been devoted to this aim for two decades. Time and effort have been made in the academic level to get a serious advance on bringing closer contractual national rules. This bottom-up approach met a stronger support in the last years although the European Parliament had “requested” the creation of a European Civil Code already in 1989. The momentous time comes in 2010 with a Green Paper from the European Commission on policy options for progress towards a European Contract Law for consumers and businesses. This Green Paper opened a public consultation period in 2011 and afterwards an expert group was appointed to draft a feasibility study for a future Instrument in European Contract Law. After all, a Proposal for a Regulation of the European Parliament and of the Council on a Common European Sales Law was adopted in October 2011 arising not few doubts, worries and misgivings from different points of view. This will be not the last step in this process.

Medicatiescreening met Beers-criteria en STOPP/START-criteria bij de ouedere patient: associatie tussen potentieel ongewenst geneesmiddelengebruik en geneesmiddelgerelateerde ziekenhuisopnamen

NARCIS (Netherlands)

Stelt, CAK; Vermeulen Windsant - van der Tweel, AMA; Egberts, ACG; Van Den Bemt, Patricia M L A; Leendertse, AJ; Hermens, W.Th.; van Marum, R.J.; Derijks, H.J.

2015-01-01

Medication screening using Beers and stopp/start criteria for elderly patients: association between potentially inappropriate medication and medication-related hospital admissions OBJECTIVE To assess the risk of medication-related hospital admissions associated with inappropriate medication use

Making doctor‐patient communication more effective from a patient’s perspective : A European mixed‐method study in general medicine settings

NARCIS (Netherlands)

Mazzi, Maria Angela

2017-01-01

The thesis investigated what in the eye of European citizens and primary care patients matters in doctor-patient communication. To include the public’s perspective in evaluating the communication quality of doctors is fundamental as patients often report quality problems in the area of communication

Compassionate use of interventions: results of a European Clinical Research Infrastructures Network (ECRIN) survey of ten European countries

LENUS (Irish Health Repository)

Whitfield, Kate

2010-11-12

Abstract Background \\'Compassionate use\\' programmes allow medicinal products that are not authorised, but are in the development process, to be made available to patients with a severe disease who have no other satisfactory treatment available to them. We sought to understand how such programmes are regulated in ten European Union countries. Methods The European Clinical Research Infrastructures Network (ECRIN) conducted a comprehensive survey on clinical research regulatory requirements, including questions on regulations of \\'compassionate use\\' programmes. Ten European countries, covering approximately 70% of the EU population, were included in the survey (Austria, Denmark, France, Germany, Hungary, Ireland, Italy, Spain, Sweden, and the UK). Results European Regulation 726\\/2004\\/EC is clear on the intentions of \\'compassionate use\\' programmes and aimed to harmonise them in the European Union. The survey reveals that different countries have adopted different requirements and that \\'compassionate use\\' is not interpreted in the same way across Europe. Four of the ten countries surveyed have no formal regulatory system for the programmes. We discuss the need for \\'compassionate use\\' programmes and their regulation where protection of patients is paramount. Conclusions \\'Compassionate use\\' is a misleading term and should be replaced with \\'expanded access\\'. There is a need for expanded access programmes in order to serve the interests of seriously ill patients who have no other treatment options. To protect these patients, European legislation needs to be more explicit and informative with regard to the regulatory requirements, restrictions, and responsibilities in expanded access programmes.

Compassionate use of interventions: results of a European Clinical Research Infrastructures Network (ECRIN) survey of ten European countries

Science.gov (United States)

2010-01-01

Background 'Compassionate use' programmes allow medicinal products that are not authorised, but are in the development process, to be made available to patients with a severe disease who have no other satisfactory treatment available to them. We sought to understand how such programmes are regulated in ten European Union countries. Methods The European Clinical Research Infrastructures Network (ECRIN) conducted a comprehensive survey on clinical research regulatory requirements, including questions on regulations of 'compassionate use' programmes. Ten European countries, covering approximately 70% of the EU population, were included in the survey (Austria, Denmark, France, Germany, Hungary, Ireland, Italy, Spain, Sweden, and the UK). Results European Regulation 726/2004/EC is clear on the intentions of 'compassionate use' programmes and aimed to harmonise them in the European Union. The survey reveals that different countries have adopted different requirements and that 'compassionate use' is not interpreted in the same way across Europe. Four of the ten countries surveyed have no formal regulatory system for the programmes. We discuss the need for 'compassionate use' programmes and their regulation where protection of patients is paramount. Conclusions 'Compassionate use' is a misleading term and should be replaced with 'expanded access'. There is a need for expanded access programmes in order to serve the interests of seriously ill patients who have no other treatment options. To protect these patients, European legislation needs to be more explicit and informative with regard to the regulatory requirements, restrictions, and responsibilities in expanded access programmes. PMID:21073691

The European Hematology Association Roadmap for European Hematology Research: a consensus document.

Science.gov (United States)

Engert, Andreas; Balduini, Carlo; Brand, Anneke; Coiffier, Bertrand; Cordonnier, Catherine; Döhner, Hartmut; de Wit, Thom Duyvené; Eichinger, Sabine; Fibbe, Willem; Green, Tony; de Haas, Fleur; Iolascon, Achille; Jaffredo, Thierry; Rodeghiero, Francesco; Salles, Gilles; Schuringa, Jan Jacob

2016-02-01

The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at €23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology of blood disorders, and has improved diagnostics and treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap.The EHA Roadmap identifies nine 'sections' in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders.The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients. Copyright© Ferrata Storti Foundation.

Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients

DEFF Research Database (Denmark)

Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy

2016-01-01

for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). Methods: The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS......-EP, including decision support tools and pathway improvement on dialysis modality choice. Linear regression models were used to examine the factors predicting three key steps: referral and receipt of UPS-EP, modality decision making, and actual delivery of preferred modality choice. A simple economic assessment...... was performed to examine the potential benefit of implementing UPS-EP in terms of dialysis costs. Results: The majority of UPS patients could receive UPS-EP (214/270 patients) and were able to make a decision (177/214), although not all patients received their preferred choice (159/177). Regression analysis...

The advantages of a small European Monetary Union

OpenAIRE

Menkhoff, Lukas; Sell, Friedrich L.

1991-01-01

The question whether European Monetary Union should include all the EC countries from the start or should initially be limited to a few core countries is again being discussed more intensely. What advantages would a small EMU have from an economic point of view? Which countries should be its founder members?

Market research and plan for Chinese fast-food restaurant start-up

OpenAIRE

Song, Tianhao

2017-01-01

CENTRIA UNIVERSITY OF APPLIED SCIENCES Market research and plan for Chinese fast-food restaurant start-up Instructor Due to the popularity of fast-food services in the Helsinki region, this thesis studies the possibility to find out the market opportunities for Chinese traditional fast-food business. Most of the fast-food restaurants opened are according to European flavor, so there is almost a void for Chinese fast-food to fill in, plus the Helsinki region is an area of ...

HOW FAR HAVE WE REACHED IN EUROPEAN COOPERATION IN CIVIL MATTERS? A VIEW ON EUROPEAN ENFORCEMENT

Directory of Open Access Journals (Sweden)

Nicolae-Horia TIT

2015-09-01

Full Text Available The EU judicial cooperation in civil matters system was developed following the needs of member states to achieve a common goal, which is to create a space of mutual recognition of judgements and distribute the juridical effects of the order created under one jurisdiction thru out the entire European space. One of the main pillars of this system is the creation of European Enforcement Orders, judgements or other titles enforceable in a member state without prior recognition of declaration of enforceability. This system has been developed other the years, starting with the European Enforcement Order for uncontested claims, continuing with the European Order for Payment procedure and European Small Claims procedure, and reaching its peak in Regulation (EU 1215/2012. By virtue of this Regulation, entered into force in January 2015, a judgment given in a Member State which is enforceable in that Member State shall be enforceable in the other Member States without any declaration of enforceability being required (art. 39. The article analyses the evolution of EU regulation regarding the enforceability of foreign judgements and the system created under Regulation (EU 1215/2012, given its importance for the judicial cooperation in civil matters and its impact on the legislation of member stated. Also, a brief analysis of the provisions of the new Romanian civil procedure Code is made, given its amendments by Law no. 138/2014.

Cooperation and teamwork in technology start-ups : reflected in some Italian, British, Dutch and German findings

NARCIS (Netherlands)

Ulijn, J.M.; Aaltio, I.; Guerra, G.; Uhlaner, L.M.

2011-01-01

Cooperation and teamwork is often a challenge for technology start-ups. Cooperation is usually needed in order to combine the variety of expertise and it requires trust between partners. The idea of national locality is changing in European enterprises because of the new shared markets and

A better START for low-acuity victims: data-driven refinement of mass casualty triage.

Science.gov (United States)

Cross, Keith P; Petry, Michael J; Cicero, Mark X

2015-01-01

Methods currently used to triage patients from mass casualty events have a sparse evidence basis. The objective of this project was to assess gaps of the widely used Simple Triage and Rapid Transport (START) algorithm using a large database when it is used to triage low-acuity patients. Subsequently, we developed and tested evidenced-based improvements to START. Using the National Trauma Database (NTDB), a large set of trauma victims were assigned START triage levels, which were then compared to recorded patient mortality outcomes using area under the receiver-operator curve (AUC). Subjects assigned to the "Minor/Green" level who nevertheless died prior to hospital discharge were considered mistriaged. Recursive partitioning identified factors associated with of these mistriaged patients. These factors were then used to develop candidate START models of improved triage, whose overall performance was then re-evaluated using data from the NTDB. This process of evaluating performance, identifying errors, and further adjusting candidate models was repeated iteratively. The study included 322,162 subjects assigned to "Minor/Green" of which 2,046 died before hospital discharge. Age was the primary predictor of under-triage by START. Candidate models which re-assigned patients from the "Minor/Green" triage level to the "Delayed/Yellow" triage level based on age (either for patients >60 or >75), reduced mortality in the "Minor/Green" group from 0.6% to 0.1% and 0.3%, respectively. These candidate START models also showed net improvement in the AUC for predicting mortality overall and in select subgroups. In this research model using trauma registry data, most START under-triage errors occurred in elderly patients. Overall START accuracy was improved by placing elderly but otherwise minimally injured-mass casualty victims into a higher risk triage level. Alternatively, such patients would be candidates for closer monitoring at the scene or expedited transport ahead of other

Development of an evaluation framework for African-European hospital patient safety partnerships.

Science.gov (United States)

Rutter, Paul; Syed, Shamsuzzoha B; Storr, Julie; Hightower, Joyce D; Bagheri-Nejad, Sepideh; Kelley, Edward; Pittet, Didier

2014-04-01

Patient safety is recognised as a significant healthcare problem worldwide, and healthcare-associated infections are an important aspect. African Partnerships for Patient Safety is a WHO programme that pairs hospitals in Africa with hospitals in Europe with the objective to work together to improve patient safety. To describe the development of an evaluation framework for hospital-to-hospital partnerships participating in the programme. The framework was structured around the programme's three core objectives: facilitate strong interhospital partnerships, improve in-hospital patient safety and spread best practices nationally. Africa-based clinicians, their European partners and experts in patient safety were closely involved in developing the evaluation framework in an iterative process. The process defined six domains of partnership strength, each with measurable subdomains. We developed a questionnaire to measure these subdomains. Participants selected six indicators of hospital patient safety improvement from a short-list of 22 based on their relevance, sensitivity to intervention and measurement feasibility. Participants proposed 20 measures of spread, which were refined into a two-part conceptual framework, and a data capture tool created. Taking a highly participatory approach that closely involved its end users, we developed an evaluation framework and tools to measure partnership strength, patient safety improvements and the spread of best practice.

Translation and discriminative validation of the STarT Back Screening Tool into Danish

DEFF Research Database (Denmark)

Morsø, Lars; Albert, Hanne; Kent, Peter

2011-01-01

OBJECTIVE: The STarT Back Screening Tool (STarT) is a nine-item patient self-report questionnaire that classifies low back pain patients into low, medium or high risk of poor prognosis. When assessed by GPs, these subgroups can be used to triage patients into different evidence-based treatment pa...

Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

1994-01-01

OBJECTIVES--To examine the pattern of survival and factors associated with the outcome of disease in patients with AIDS. DESIGN--Inception cohort. Data collected retrospectively from patients' charts. SETTING--52 clinical centres in 17 European countries. SUBJECTS--6578 adults diagnosed with AIDS....... The regional differences in survival were less pronounced for patients diagnosed in 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to define AIDS but was significant only for patients diagnosed with Pneumocystis carinii...... pneumonia. The three year survival, however, remains unchanged over time. CONCLUSIONS--Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Europe. The magnitude of these differences, however, has declined gradually over time. Short term survival has...

The Europeanization of the Romanian Society and the Tendential Modernity

Directory of Open Access Journals (Sweden)

Constantin Schifirneț

2011-01-01

Full Text Available The study examines the tendential modernity as an explanatory factor of the particularities of the Europeanization of the Romanian society. I start from the thesis that the evolution of the Europeanization process in Romania is closely associated with the process of accession to the European Union, finalized after the passing through a sinuous and difficult route. The analysis of the Europeanization of the Romanian society pursues the stages of its formation in the local context. Due to the fact thatRomaniawill still continue to be a society in transition, the most critical and relevant problem regards the dependency of the Romanian society on the strong societies inEurope. Under these circumstances, the question is, whetherRomaniawill represent a periphery ofEurope, or a national community with a European standard of development. Europeanization in its real sense does not mean “westernization”. Through the adherence to the European Union, Romanian society has the chance to put an end to the successive transitions known over its modern history, generators of tendential modernity. The Europeanization constitutes the fundamental purpose of the modernization processes of the Romanian society.

European Union competition law, intellectual property law and standardization

NARCIS (Netherlands)

Geradin, Damien; Contreras, Jorge L.

2016-01-01

This paper provides an overview of the efforts of the European Commission to identify and, when necessary, challenge anticompetitive behaviour with respect to standardization and the licensing of standardized technologies, as well as the case-law of the CJEU on the same subject. The paper starts by

Start of the international tokamak physics activity

International Nuclear Information System (INIS)

Campbell, D.

2001-01-01

This newsletter comprises a summary on the start of the International Tokamak Physics activity (ITPA) by Dr. D. Campbell, Chair of the ITPA Co-ordinating Committee. As the ITER EDA drew to a close, it became clear that it was desirable to establish a new mechanism in order to promote the continued development of the physics basis for burning plasma experiments and to preserve the invaluable collaborations between the major international fusion communities which had been established through the ITER physics expert groups. As a result of the discussions of the representatives of the European Union, Japan, the Russian Federation and the United States the agreed principles for conducting the International Tokamak Physics Activity (ITPA) were elaborated and ITPA topical physics groups were organized

Prasugrel vs. clopidogrel in contemporary Western European patients with acute coronary syndromes receiving drug-eluting stents

DEFF Research Database (Denmark)

Wein, Bastian; Coslovsky, Michael; Jabbari, Reza

2017-01-01

BACKGROUND: Clinical and cost-effectiveness of prasugrel vs. clopidogrel in acute coronary syndrome (ACS) was only evaluated using TRITON-TIMI 38 event rates. A comparative analysis of both drugs in contemporary European ACS patients is lacking. METHODS: To address this issue, cardiac and bleedin......=0.255), but more major bleedings (4.0% vs. 1.7%, pexpenditures per patient: 1116.3 (DNK), 1063.5 (GER) and 880.8 (SUI) EURO, respectively. Accordingly, incremental cost...

Reproduction of European Eel in Aquaculture (REEL)

DEFF Research Database (Denmark)

Tomkiewicz, Jonna; Tybjerg, Lars; Støttrup, Josianne

for the development of methods to reproduce European eel in aquaculture. Two major projects: Artificial Reproduction of Eels II and III (ROE II and III) succeeded during 2005-2008 to produce viable eggs and larvae that lived up to 12 days. The larvae thereby accomplished the yolk-sac stage and became ready to start...... feeding. The results were in particular promising because they evidenced that methods successfully applied to Japanese eel has a potential for application also to the European eel. ROE II and III were supported by the Ministry of Food, Agriculture and Fisheries and the European Commission through...... the Financial Instrument for Fisheries Guidance (FIFG) and the Danish Food Research Program 2006, respectively. Results: The REEL project accomplished through three series of experiments to consolidate previous results. The longevity of larvae was extended from 12 to 20 days after hatch in first feeding...

Linac design for the European spallation source

Energy Technology Data Exchange (ETDEWEB)

Klein, H. [Universitaet Postfach, Frankfurt am Main (Germany)

1995-10-01

A study group has started to develop a conceptual design for a European Spallation Source (ESS). This pulsed 5 MW source presently consists of a 1.334 GeV linac and two compressor rings. In the following mainly the high intensity linac part will be discussed, which has some features of interest for accelerators for transmutation of radioactive waste too.

Towards cooperation between European start ups : the position of the French, Dutch, and German entrepreneurial and innovative engineer

NARCIS (Netherlands)

Ulijn, J.M.; Fayolle, A.

2002-01-01

People who want to start their own business often try to survive or to die again on their own. The very fact that "others", apart from family, friends and fools who invest in their venture, are quickly seen as probable competitors, who want the steal the idea, prevent start ups from cooperation with

Gender differences in patients starting long-term home mechanical ventilation due to obesity hypoventilation syndrome.

Science.gov (United States)

Palm, Andreas; Midgren, Bengt; Janson, Christer; Lindberg, Eva

2016-01-01

Obesity hypoventilation syndrome (OHS) is often diagnosed late. The aim of this study was to analyse gender differences at initiation of long-term mechanical ventilation (LTMV) in patients with (OHS), to analyse gender differences in treatment effect and to study how the prescription of LTMV due to OHS has changed over time. Data on patients on LTMV due to OHS between 1996 and 2014 were obtained from Swedevox, a nationwide health quality registry of patients on LTMV in Sweden. When starting LTMV, women were generally older (age 64.4 ± 11.2 vs. 60.1 ± 12.1 years, p obese (BMI 43.0 ± 8.2 vs. 41.5 ± 7.9 kg/m2, p differ. During the study period, the age of patients at the initiation of LTMV rose by 3.4 years/decade (P = 0.001) in women and with 1.9 years/decade (P = 0.048) in men but there were no significant changes in BMI (P = 0.425). Diagnosis of OHS is more delayed in women and as a consequence the disease is more advanced when diagnosed. In spite of this, there is no gender difference in survival rate in patients with OHS treated with LTMV. More and older patients with OHS nowadays gain access to LTMV. Copyright © 2015 Elsevier Ltd. All rights reserved.

European road users’ risk perception and mobility : the SARTRE 4 survey.

OpenAIRE

Antov, D. Banet, A. Barbier, C. Bellet, T. Bimpeh, Y. Boulanger, A. Brandstätter, C. Britschgi, V. Brosnan, M. Buttler, I. Cestac, J. , De Craen, S. de Delhomme, P. Dogan, E. Drápela, E. Forward, S. Freeman, R. Furian, G. Gábor, M. Goldenbeld, C. Henriksson, P. Holte, H. Kraïem, S. Papadimitriou, E. Podlesek, A. Polic, M. Sánchez-Martín, F. Sardi, G.-M. Schmidt, E.-A. Silverans, P. Siska, T. Skládaná, P. Theofilatos, A. Below, A. von Yannis, G. Zaidel, D. & Zavrides, N.

2012-01-01

The SARTRE (Social Attitudes to Road Traffic Risk in Europe) project started in 1991. It consists of a European wide survey about knowledge of road traffic laws and road traffic risks, attitudes regarding road safety issues, reported road traffic behaviours, transport habits and needs in several European countries. Various topics related to road safety are in the focus of the project such as alcohol, drugs, or phone use while driving, speeding, use of advanced driver assistance systems and th...

Highlights from e-EPS: New milestone reached for the European XFEL construction

CERN Multimedia

Jorge Rivero González

2013-01-01

e-EPS News is an addition to the CERN Bulletin line-up, showcasing articles from e-EPS – the European Physical Society newsletter – as part of a collaboration between the two publications.   In June 2013 an important milestone was reached for the European X-ray free-electron laser [XFEL] with the completion of its underground portion. Located in the Hamburg area (Germany), the European XFEL is one of the largest and most ambitious European projects to date. Starting full operations in 2016, the European XFEL is expected to generate intensive, ultrashort X-ray flashes that will open up entirely new areas of research with X-rays that are currently inaccessible. Organisations from 12 European countries, Denmark, France, Germany, Greece, Hungary, Italy, Poland, Russia, Slovakia, Spain, Sweden and Switzerland are members of the European XFEL consortium, with the Deutsches Elektronen-Synchrotron [DESY] as the main shareholder. The total length of the facility will be 3.4km and ...

The mandibular symphysis as a starting point for the occlusal-level reconstruction of panfacial fractures with bicondylar fractures and interruption of the maxillary and mandibular arches: report of two cases.

Science.gov (United States)

Pau, Mauro; Reinbacher, Knut Ernst; Feichtinger, Matthias; Navysany, Kawe; Kärcher, Hans

2014-06-01

Panfacial fractures represent a challenge, even for experienced maxillofacial surgeons, because all references for reconstructing the facial skeleton are missing. Logical reconstructive sequencing based on a clear understanding of the correlation between projection and the widths and lengths of facial subunits should enable the surgeon to achieve correct realignment of the bony framework of the face and to prevent late deformity and functional impairment. Reconstruction is particularly challenging in patients presenting with concomitant fractures at the Le Fort I level and affecting the palate, condyles, and mandibular symphysis. In cases without bony loss and sufficient dentition, we believe that accurate fixation of the mandibular symphysis can represent the starting point of a reconstructive sequence that allows successful reconstruction at the Le Fort I level. Two patients were treated in our department by reconstruction starting in the occlusal area through repair of the mandibular symphysis. Both patients considered the postoperative facial shape and profile to be satisfactory and comparable to the pre-injury situation. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The Consolidation on Banking Supervision in the Context of a Pan European Banking System

OpenAIRE

Teodora Barbu; Georgeta Vintila

2007-01-01

The diversity of national banking systems in the European banking system and the absence of consolidated supervision creates the premises for a series of interrogations whose essence is the same: Is it possible to discuss about a Pan European Banking System? The starting point in answering this question was the efforts to create a single banking market, which took place in 1973-1999, and the impact of integration on the European Banking Industry. Among the most representative aspects, it must...

Euthanasia and physician-assisted suicide: A white paper from the European Association for Palliative Care.

Science.gov (United States)

Radbruch, Lukas; Leget, Carlo; Bahr, Patrick; Müller-Busch, Christof; Ellershaw, John; de Conno, Franco; Vanden Berghe, Paul

2016-02-01

In recognition of the ongoing discussion on euthanasia and physician-assisted suicide, the Board of Directors of the European Association for Palliative Care commissioned this white paper from the palliative care perspective. This white paper aims to provide an ethical framework for palliative care professionals on euthanasia and physician-assisted suicide. It also aims to provide an overview on the available evidence as well as a discourse of ethical principles related to these issues. Starting from a 2003 European Association for Palliative Care position paper, 21 statements were drafted and submitted to a five-round Delphi process A panel with 17 experts commented on the paper in round 1. Board members of national palliative care or hospice associations that are collective members of European Association for Palliative Care were invited to an online survey in rounds 2 and 3. The expert panel and the European Association for Palliative Care board members participated in rounds 4 and 5. This final version was adopted as an official position paper of the European Association for Palliative Care in April 2015. Main topics of the white paper are concepts and definitions of palliative care, its values and philosophy, euthanasia and physician-assisted suicide, key issues on the patient and the organizational level. The consensus process confirmed the 2003 European Association for Palliative Care white paper and its position on the relationship between palliative care and euthanasia and physician-assisted suicide. The European Association for Palliative Care feels that it is important to contribute to informed public debates on these issues. Complete consensus seems to be unachievable due to incompatible normative frameworks that clash. © The Author(s) 2015.

Brexit and the European Union

DEFF Research Database (Denmark)

Jensen, Mads Dagnis; Snaith, Holly

2018-01-01

When on 23 June 2016 a majority voted in favour of the United Kingdom (UK) leaving the European Union (EU), it generated a host of unknowns. Prior to the referendum, scholars had already started to anticipate the implications of a potential Brexit from different perspectives, including considering...... lie and suggesting where Britain’s exit will leave the greatest strategic vacuums. The subsequent analysis centres on the actors that will likely win and lose from the UK’s exit from the Union....

A New Perspective of Investment Modelling at the European Union Level

Directory of Open Access Journals (Sweden)

Alin OPREANA

2015-08-01

Full Text Available The study that represents the subject of this paper follows the analysis of the investment function and the influencing factors at the European Union level. The research has, as a starting point, the hypothesis that there is a negative relationship between the European Union investments and tax rates. For verifying this hypothesis, the structural equation modeling is used (SEM, and the same technique is applied in the second part of the research, which will track the development of the investments’ model at the European Union level. The results will highlight the relationships that are established between specific variables that characterize the volume of investments.

Underweight, overweight and obesity in paediatric dialysis and renal transplant patients.

Science.gov (United States)

Bonthuis, Marjolein; van Stralen, Karlijn J; Verrina, Enrico; Groothoff, Jaap W; Alonso Melgar, Ángel; Edefonti, Alberto; Fischbach, Michel; Mendes, Patricia; Molchanova, Elena A; Paripović, Dušan; Peco-Antic, Amira; Printza, Nikoleta; Rees, Lesley; Rubik, Jacek; Stefanidis, Constantinos J; Sinha, Manish D; Zagożdżon, Ilona; Jager, Kitty J; Schaefer, Franz

2013-11-01

The prevalence of childhood overweight is rising worldwide, but in children on renal replacement therapy (RRT) a poor nutritional status is still the primary concern. We aimed to study the prevalence of, and factors associated with, underweight and overweight/obesity in the European paediatric RRT population. Moreover, we assessed the evolution of body mass index (BMI) after the start of RRT. We included 4474 patients younger than 16 years from 25 countries of whom BMI data, obtained between 1995 and 2010, were available within the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry. Prevalence estimates for under- and overweight/obesity were calculated using age and sex-specific criteria of the World Health Organization (WHO, 0-1 year olds) and the International Obesity Task Force cut-offs (2-15 year olds). The prevalence of underweight was 3.5%, whereas 20.8% of the patients were overweight and 12.5% obese. Factors associated with being underweight were receiving dialysis treatment and infant age. Among transplanted recipients, a very short stature (OR: 1.64, 95% CI: 1.40-1.92) and glucocorticoid treatment (OR: 1.23, 95% CI: 1.03-1.47) were associated with a higher risk of being overweight/obese. BMI increased post-transplant, and a lower BMI and a higher age at the start of RRT were associated with greater BMI changes during RRT treatment. Overweight and obesity, rather than underweight, are highly prevalent in European children on RRT. Short stature among graft recipients had a strong association with overweight, while underweight appears to be only a problem in infants. Our findings suggest that nutritional management in children receiving RRT should focus as much on the prevention and treatment of overweight as on preventing malnutrition.

The Role of European Union Funds in Economic Development

Directory of Open Access Journals (Sweden)

Cristian PĂUN

2015-09-01

Full Text Available The European Union project initially started as a peaceful solution for war reconstruction in Europe. European countries decided to cooperate rather than compete in an aggressive way. At the beginning, this project supposed (involved market liberalization, trade barriers removals, market access improvement (initially for coal, steel, energy and, later, for all goods, services, workforce and capital. Unfortunately, in the last decades, all these Single Market facilities have been backed by redistributive schemes, protectionist mechanisms, social engineering, subsidies and facilities packed in so-called ”EU policies”. New ”European” institutions have been created, more and more funds have been involved to financially support this very complex redistributive intervention. The political dimension of the European Union project enhanced the economic dimension and constantly suffocated private markets and the economy. The “incomes” of the European Union that fuel its financial support are coming from taxes and/or inflation (better administered after the introduction of a Single Currency – the Euro. This paper will discuss the relevance of European Funds for economic development, especially for new members in this project.

Development and influence of European and American university libraries

Directory of Open Access Journals (Sweden)

Irena Sapač

2000-01-01

Full Text Available The author compares the development of university libraries in Europe and in the United States of America. She finds that the university libraries in the United States of America have developed for three centuries under the influence of the European libraries, but now in the last century the European libraries have developed under the influence of the American ones. In times when there were no professional librarians, the American university libraries were managed by university professors, who were educated at European universities. The European management patterns were consequently applied also to the American libraries. The first books were also first brought from Europe. The Humboldt university also had a strong influence on the development of the American university libraries. Not until the second half of the 19th and especially the 20th century did the American university libraries achieve such high levels of cataloguing, classification, co-operation, organisation, computer networks, information holders, education and constructing library buildings that the European libraries started assuming their methods.

Random start ovarian stimulation for fertility preservation appears unlikely to delay initiation of neoadjuvant chemotherapy for breast cancer.

Science.gov (United States)

Letourneau, Joseph M; Sinha, Nikita; Wald, Kaitlyn; Harris, Eve; Quinn, Molly; Imbar, Tal; Mok-Lin, Evelyn; Chien, A Jo; Rosen, Mitchell

2017-10-01

who did not undergo ovarian stimulation (P start chemotherapy, ongoing oncology work-up and treatment planning, FP decision-making, and the pursuit of second and third opinions. The difference in time from referral to FP consultation may have also influenced patients' decisions about whether to undergo ovarian stimulation. In this study, FP with random start ovarian stimulation was not associated with a delay cancer treatment in the neoadjuvant setting, so long as there was a prompt FP referral. Patients undergoing neoadjuvant chemotherapy should be informed of these findings to avoid unnecessary anxiety due to concern for delays. This study was supported by departmental research funding within the University of California, San Francisco Department of Obstetrics, Gynecology and Reproductive Sciences. There are no conflicts of interest to declare. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Convergence of the National Public Administration Systems within the European Union in the Context of the European Model Emergence

Directory of Open Access Journals (Sweden)

Cezar Corneliu MANDA

2015-09-01

Full Text Available The long running history for over half a century of the European Union was marked initially by the need to approach the member states’ administrations, with a view to getting them more compatible, as a prerequisite of the EU’s functioning, at the foreseen political-legal and economic parameters, and then the respective tendency started to intensify progressively relative to the more and more ambitious goals and objectives of the European Union establishment. Today we witness an increased dynamics of such a process which seems to integrate even the specificities derived from the sovereignty elements, considered not long ago as sacred, at the states level, a processuality whose finality consists in the continuous consolidation of the European administrative area, as an essential corollary to the effective inter-community mechanisms development, equally as an effect of the states’ integration but also a condition for the European project success. In such a context, the present approach proposes to analyse and identify the degree of cohesion and of similarity between the EU states administrations, which revolve around the emergence of the common characteristics, considered as authentic values of the administrative area, susceptible to be accepted altogether as bases for the European administration model, whose outline tends to become more visible.

The general practitioner as the first contacted health professional by patients with psychosocial problems: a European study.

NARCIS (Netherlands)

Boerma, W.G.W.; Verhaak, P.F.M.

1999-01-01

Background: there are considerable differences between and within countries in the involvement of general practitioners (GPs) in psychosocial care. This study aimed to describe the self-perceived role of GPs in 30 European countries as the first contacted professional for patients with psychosocial

The European anchovy (Engraulis encrasicolus) increase in the North Sea

NARCIS (Netherlands)

Raab, K.E.

2013-01-01

Small pelagic fish such as anchovy are of high socio-economic importance worldwide. They are known for strong fluctuations in abundance, for which the mechanisms are not always understood. European anchovy (Engraulis encrasicolus) increased its population in the North Sea starting in

A GLANCE AT THE EUROPEAN ENERGY MARKET LIBERALIZATION

Directory of Open Access Journals (Sweden)

Delia Vasilica Rotaru

2013-03-01

Full Text Available This paper offers a presentation on the liberalization process on the energy markets that started two decades ago and takes place across Europe in the attempt to create a single European energy market. Several benefits are expected following the deregulation process such as higher competition, market transparency, lower prices, increased efficiency and product development in the clients favour. Three very different energy markets are analyzed before and after the liberalization process – UK, Germany and France – a short insight on the current Romanian energy market is also offered. The aim of this paper is to provide a better understanding on liberalizing European energy markets.

European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers

Science.gov (United States)

Kotecha, Dipak; Chua, Winnie W L; Fabritz, Larissa; Hendriks, Jeroen; Casadei, Barbara; Schotten, Ulrich; Vardas, Panos; Heidbuchel, Hein; Dean, Veronica; Kirchhof, Paulus

2018-01-01

Abstract We are in the midst of a digital revolution in health care, although the application of new and useful technology in routine clinical practice is variable. The Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly (CATCH ME) Consortium, in collaboration with the European Society of Cardiology (ESC), has funded the creation of two applications (apps) in atrial fibrillation (AF) for use in smartphones and tablets. The patient app aims to enhance patient education, improve communication between patients and health care professionals, and encourage active patient involvement in the management of their condition. The health care professional app is designed as an interactive management tool incorporating the new ESC Practice Guidelines on AF and supported by the European Heart Rhythm Association (EHRA), with the aim of improving best practice approaches for the care of patients with AF. Both stand-alone apps are now freely available for Android and iOS devices though the Google Play, Amazon, and Apple stores. In this article, we outline the rationale for the design and implementation of these apps. Our objective is to demonstrate the value of integrating novel digital technology into clinical practice, with the potential for patient engagement, optimization of pharmacological and interventional therapy in AF, and ultimately to improve patient outcomes. PMID:29040548

Patient engagement with research: European population register study.

Science.gov (United States)

McKevitt, Christopher; Fudge, Nina; Crichton, Siobhan; Bejot, Yannick; Daubail, Benoît; Di Carlo, Antonio; Fearon, Patricia; Kolominsky-Rabas, Peter; Sheldenkar, Anita; Newbound, Sophie; Wolfe, Charles D A

2015-12-01

Lay involvement in implementation of research evidence into practice may include using research findings to guide individual care, as well as involvement in research processes and policy development. Little is known about the conditions required for such involvement. To assess stroke survivors' research awareness, use of research evidence in their own care and readiness to be involved in research processes. Cross sectional survey of stroke survivors participating in population-based stroke registers in six European centres. The response rate was 74% (481/647). Reasons for participation in register research included responding to clinician request (56%) and to 'give something back' (19%); however, 20% were unaware that they were participating in a stroke register. Research awareness was generally low: 57% did not know the purpose of the register they had been recruited to; 73% reported not having received results from the register they took part in; 60% did not know about any research on stroke care. Few participants (7.6%) used research evidence during their consultations with a doctor. The 34% of participants who were interested in being involved in research were younger, more highly educated and already research aware. Across Europe, stroke survivors already participating in research appear ill informed about stroke research. Researchers, healthcare professionals and patient associations need to improve how research results are communicated to patient populations and research participants, and to raise awareness of the relationship between research evidence and increased quality of care. © 2014 John Wiley & Sons Ltd.

Emerging Administrations under European Union Rules

Directory of Open Access Journals (Sweden)

Bogdan Berceanu

2012-05-01

Full Text Available The idea of emergence is generally used to indicate the appearance of patterns, structures, orproperties that cannot be adequately explained by referring only to the system’s pre-existing componentsand their interactions. The term “emergence” has an interdisciplinary approach specific to administrativesciences, too. In this article, the concept of “emergence” signifies lato sensu a kind of change and it will beused to refer to countries that have a high volatility and that are in transition and to define the changes thatsuffer the public administrations of the countries which are part of the European construction. EuropeanUnion through its policies and legislation has a great impact on economic and social conditions in MemberStates. The aim of the paper is to present a theoretical approach on the dimension of emergingadministrations understood as changes and reforms that suffer the institutions from the EU member statesunder the pressure of the European Union rules. The study is using the concept of emergence to researchand to analyze the nature of the changes in the public administration starting from the approach of thesystems theory.

Antibiotic prescribing in patients with acute rhinosinusitis is not in agreement with European recommendations

DEFF Research Database (Denmark)

Jørgensen, Lars Christian; Friis Christensen, Sarah; Cordoba Currea, Gloria

2013-01-01

Abstract Objective. To assess the potential overprescribing in patients with acute rhinosinusitis across six countries with different antibiotic prescribing rates and different prevalence of antibiotic resistance. Design, setting and subjects. A cross-sectional study including GPs from two Nordic...... tract infections" (HAPPY AUDIT). Main outcome measures. Use of antibiotics for acute rhinosinusitis based on the recommendations in the European Position Paper on Rhinosinusitis and Nasal Polyps 2007 (EP3OS). Results. In total, 618 participating GPs registered 33 273 patients with RTI of whom 1150 (3...... overprescribing) and 23% had symptoms recommendations (EP3OS guidelines). To prevent overprescribing, efforts should be made to implement...

The Sydney Triage to Admission Risk Tool (START): A prospective validation study.

Science.gov (United States)

Ebker-White, Anja A; Bein, Kendall J; Dinh, Michael M

2018-02-08

The present study aims to prospectively validate the Sydney Triage to Admission Risk Tool (START) to predict ED disposition. This was a prospective validation study at two metropolitan EDs in Sydney, Australia. Consecutive triage encounters were observed by a trained researcher and START scores calculated. The primary outcome was patient disposition (discharge or inpatient admission) from the ED. Multivariable logistic regression was used to estimate area under curve of receiver operator characteristic (AUC ROC) for START scores as well as START score in combination with other variables such as frailty, general practitioner referral, overcrowding and major medical comorbidities. There were 894 patients analysed during the study period. The START score when applied to the data had AUC ROC of 0.80 (95% CI 0.77-0.83). The inclusion of other clinical variables identified at triage did not improve the overall performance of the model with an AUC ROC of 0.81 (95% CI 0.78-0.84) in the present study. The overall performance of the START tool with respect to model discrimination and accuracy has been prospectively validated. Further clinical trials are required to test the clinical effectiveness of the tool in improving patient flow and overall ED performance. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Youth, unemployment, and male gender predict mortality in AIDS patients started on HAART in Nigeria.

Science.gov (United States)

DeSilva, Malini B; Merry, Stephen P; Fischer, Philip R; Rohrer, James E; Isichei, Christian O; Cha, Stephen S

2009-01-01

This retrospective study identifies risk factors for mortality in a cohort of HIV-positive adult patients treated with highly active antiretroviral therapy (HAART) in Jos, Nigeria. We analyzed clinical data from a cohort of 1552 patients enrolled in a HIV/acquired immune deficiency syndrome treatment program and started on HAART between December 2004 and 30 April 2006. Death was our study endpoint. Patients were followed in the study until death, being lost to follow-up, or the end of data collection, 1 December 2006. Baseline patient characteristics were compared using Wilcoxon Rank Sum Test for continuous variables and Pearson Chi-Square test for categorical variables to determine if certain demographic factors were associated with more rapid progression to death. The Cox proportional hazard multivariate model analysis was used to find risk factors. As of 1 December 2006, a total of 104 cases progressed to death. In addition to the expected association of CD4 count less than 50 at initiation of therapy and active tuberculosis with mortality, the patient characteristics independently associated with a more rapid progression to death after initiation of HAART were male gender, age less than 30 years old, and unemployment or unknown occupation status. Future research is needed to identify the confounding variables that may be amenable to targeted interventions aimed at ameliorating these health disparities.

European Integration and Outward FDI from Central and Eastern Europe

DEFF Research Database (Denmark)

Jindra, B.; Hassan, S. S.; Gunther, J.

2015-01-01

countries (CEECs) within the EU 27 (1996-2010). We find that the EU integration process is related with increasing importance of market access and less emphasis on labour cost advantages. We find heterogeneity in the valuation of foreign knowledge-related assets. The location probability within the EU15......The European Union (EU) Member States in central and eastern Europe (CEE) witnessed a surge in outward foreign direct investment (OFDI) between 2000 and the start of the global financial crisis. This article investigates whether the European integration process altered the relative importance...

Position statement on the role of healthcare professionals, patient organizations and industry in European Reference Networks

NARCIS (Netherlands)

Hollak, C.E.; Biegstraaten, M.; Baumgartner, M.R.; Belmatoug, N.; Bembi, B.; Bosch, A. van den; Brouwers, M.; Dekker, H.; Dobbelaere, D.; Engelen, M.; Groenendijk, M.C.; Lachmann, R.; Langendonk, J.G.; Langeveld, M.; Linthorst, G.; Morava, E.; Poll-The, B.T.; Rahman, S.; Rubio-Gozalbo, M.E.; Spiekerkoetter, U.; Treacy, E.; Wanders, R.; Zschocke, J.; Hagendijk, R.

2016-01-01

A call from the EU for the set-up of European Reference Networks (ERNs) is expected to be launched in the first quarter of 2016. ERNs are intended to improve the care for patients with low prevalent or rare diseases throughout the EU by, among other things, facilitating the pooling and exchange of

Position statement on the role of healthcare professionals, patient organizations and industry in European Reference Networks

NARCIS (Netherlands)

C.E.M. Hollak (Carla); M. Biegstraaten (Marieke); M.R. Baumgartner (Matthias R.); N. Belmatoug (Nadia); B. Bembi (Bruno); A.M. Bosch (Annet); M.C.G.J. Brouwers (M. C G J); H. Dekker (Hanka); D. Dobbelaere (Dries); M. Engelen (Marc); M.C. Groenendijk (Marike C.); R.H. Lachmann (Robin); J.G. Langendonk (Janneke); M. Langeveld (Mirjam); G. Linthorst (Gabor); E. Morava (Eva); B.T. Poll-The; S. Rahman (Shamima); M.E. Rubio-Gozalbo (Estela); U. Spiekerkoeter (Ute); E. Treacy (Eileen); R.J.A. Wanders (Ronald); J. Zschocke (Johannes); R. Hagendijk (Rob)

2016-01-01

textabstractA call from the EU for the set-up of European Reference Networks (ERNs) is expected to be launched in the first quarter of 2016. ERNs are intended to improve the care for patients with low prevalent or rare diseases throughout the EU by, among other things, facilitating the pooling and

Performance of an easy-to-use prediction model for renal patient survival: an external validation study using data from the ERA-EDTA Registry.

Science.gov (United States)

Hemke, Aline C; Heemskerk, Martin B A; van Diepen, Merel; Kramer, Anneke; de Meester, Johan; Heaf, James G; Abad Diez, José Maria; Torres Guinea, Marta; Finne, Patrik; Brunet, Philippe; Vikse, Bjørn E; Caskey, Fergus J; Traynor, Jamie P; Massy, Ziad A; Couchoud, Cécile; Groothoff, Jaap W; Nordio, Maurizio; Jager, Kitty J; Dekker, Friedo W; Hoitsma, Andries J

2018-01-16

An easy-to-use prediction model for long-term renal patient survival based on only four predictors [age, primary renal disease, sex and therapy at 90 days after the start of renal replacement therapy (RRT)] has been developed in The Netherlands. To assess the usability of this model for use in Europe, we externally validated the model in 10 European countries. Data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry were used. Ten countries that reported individual patient data to the registry on patients starting RRT in the period 1995-2005 were included. Patients prediction model was evaluated for the 10- (primary endpoint), 5- and 3-year survival predictions by assessing the calibration and discrimination outcomes. We used a data set of 136 304 patients from 10 countries. The calibration in the large and calibration plots for 10 deciles of predicted survival probabilities showed average differences of 1.5, 3.2 and 3.4% in observed versus predicted 10-, 5- and 3-year survival, with some small variation on the country level. The concordance index, indicating the discriminatory power of the model, was 0.71 in the complete ERA-EDTA Registry cohort and varied according to country level between 0.70 and 0.75. A prediction model for long-term renal patient survival developed in a single country, based on only four easily available variables, has a comparably adequate performance in a wide range of other European countries. © The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Industrial strategies on the European gas market. Unternehmensstrategien auf dem europaeischen Gasmarkt

Energy Technology Data Exchange (ETDEWEB)

Chevalier, J M [Univ. de Paris-Dauphine, Centre de Geopolitique de l' Energie et de Matieres Premieres, 75 (France)

1992-09-01

The European natural gas industry is faced with two main problems. On the one hand it has to satisfy strongly rising demands while on the other hand its traditional structure is being questioned especially by the European commission in Brussels. The main reasons for the rising demand is the stoppage of nuclear energy programs in all European states except France. Almost all European countries have therefore started large programmes for the building of gas power stations. As a consequence, Europe has to develop large new sources of supply in order to satisfy this demand. The deregulation demanded by Brussels is the logical consequence of the legal principles contained in the Roman Treaties: Free movement of goods, persons and capital, the right of establishment and competition. (orig./UA).

An epidemiological study of hemodialysis patients based on the European Fresenius Medical Care hemodialysis network: results of the ARO study.

Science.gov (United States)

de Francisco, Angel L M; Kim, Joseph; Anker, Stefan D; Belozeroff, Vasily; Canaud, Bernard; Chazot, Charles; Drüeke, Tilman B; Eckardt, Kai-Uwe; Floege, Jürgen; Kronenberg, Florian; Macdougall, Iain C; Marcelli, Daniele; Molemans, Bart; Passlick-Deetjen, Jutta; Schernthaner, Guntram; Stenvinkel, Peter; Wheeler, David C; Fouqueray, Bruno; Aljama, Pedro

2011-01-01

ARO, an observational study of hemodialysis (HD) patients in Europe, aims to enhance our understanding of patient characteristics and practice patterns to improve patient outcome. HD patients (n = 8,963) from 134 Fresenius Medical Care facilities treated between 2005 and 2006 were randomly selected from 9 European countries (Czech Republic, France, Hungary, Italy, Poland, Portugal, Spain, Slovak Republic and Slovenia) and Turkey. Information was captured on demographics, comorbidities, medications, laboratory and dialysis parameters, and outcome. Patients were followed for 1.4 ± 0.7 years. Wide variation by country was observed for age, sex and diabetes as a cause of chronic kidney disease. Cardiovascular disease was present in 73% of patients. Dialysis parameters were homogeneous across countries. Arteriovenous fistulas were frequently used (73%). More incident patients had hemoglobin <11 g/dl than prevalent patients (50 vs. 33%, respectively). Phosphatemia and intact parathyroid hormone were similar between incident and prevalent patients (4.7 ± 1.2 mg/dl and 190 vs. 213 ng/l, respectively). Medication use varied widely by country. In total, 5% of patients underwent renal transplantation. Overall death rate was 124/1,000 patient-years. ARO revealed differences in HD practice patterns and patient characteristics in the 10 participating countries. Future ARO studies will fill gaps in the knowledge about the care of European HD patients. Copyright © 2010 S. Karger AG, Basel.

ANALYSIS OF LABOUR MARKET IN ROMANIA AND THE EUROPEAN UNION

Directory of Open Access Journals (Sweden)

Tanase Diana

2013-07-01

Full Text Available The paper aims at analysing the labour market, one of the most complex forms of market in economy. The present work forwards a comparative survey regarding the labour market in Romania and in the other European Union member states. The paper starts by highlighting general aspects related to labour market and continues by the presentation of the European Union countries’ ranking according to the labour market efficiency, top elaborated on the basis of the World Economic Forum data. Furthermore, the paper analyses labour productiveness, employment rate and unemployment rate both in Romania and in the other countries of the European Union. In the end the authors forward conclusions regarding the possibilities of increasing competitiveness on Romania’s labour market.

Awareness of General Practitioners concerning cancer patients' preferences for place of death: Evidence from four European countries

NARCIS (Netherlands)

Ko, W.; Beccaro, M.; Miccinesi, G.; van Casteren, V.; Donker, G.A.; Onwuteaka-Philipsen, B.D.; Espi, M.T.; Deliens, L.; Costantini, M.; Block, L.

2013-01-01

Background: General Practitioners (GPs) are at the first level of contact in many European healthcare systems and they supposedly have a role in supporting cancer patients in achieving their desired place of death. A four-country (Belgium, the Netherlands, Italy and Spain) study was carried out

Cross border reproductive care in six European countries

DEFF Research Database (Denmark)

de Mouzon, J; Pennings, G; Ferraretti, A P

2010-01-01

The quantity and the reasons for seeking cross border reproductive care are unknown. The present article provides a picture of this activity in six selected European countries receiving patients.......The quantity and the reasons for seeking cross border reproductive care are unknown. The present article provides a picture of this activity in six selected European countries receiving patients....

Development and validation of the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ) for primary care patients with type 2 diabetes.

Science.gov (United States)

Fu, Sau Nga; Chin, Weng Yee; Wong, Carlos King Ho; Yeung, Vincent Tok Fai; Yiu, Ming Pong; Tsui, Hoi Yee; Chan, Ka Hung

2013-01-01

To develop and evaluate the psychometric properties of a Chinese questionnaire which assesses the barriers and enablers to commencing insulin in primary care patients with poorly controlled Type 2 diabetes. Questionnaire items were identified using literature review. Content validation was performed and items were further refined using an expert panel. Following translation, back translation and cognitive debriefing, the translated Chinese questionnaire was piloted on target patients. Exploratory factor analysis and item-scale correlations were performed to test the construct validity of the subscales and items. Internal reliability was tested by Cronbach's alpha. Twenty-seven identified items underwent content validation, translation and cognitive debriefing. The translated questionnaire was piloted on 303 insulin naïve (never taken insulin) Type 2 diabetes patients recruited from 10 government-funded primary care clinics across Hong Kong. Sufficient variability in the dataset for factor analysis was confirmed by Bartlett's Test of Sphericity (P 0.4 and Eigenvalues >1. Total variance for the 10 factors was 66.22%. Kaiser-Meyer-Olkin measure was 0.725. Cronbach's alpha coefficients for the first four factors were ≥0.6 identifying four sub-scales to which 13 items correlated. Remaining sub-scales and items with poor internal reliability were deleted. The final 13-item instrument had a four scale structure addressing: 'Self-image and stigmatization'; 'Factors promoting self-efficacy; 'Fear of pain or needles'; and 'Time and family support'. The Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ) appears to be a reliable and valid measure for assessing barriers to starting insulin. This short instrument is easy to administer and may be used by healthcare providers and researchers as an assessment tool for Chinese diabetic primary care patients, including the elderly, who are unwilling to start insulin.

Development and validation of the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ for primary care patients with type 2 diabetes.

Directory of Open Access Journals (Sweden)

Sau Nga Fu

Full Text Available OBJECTIVES: To develop and evaluate the psychometric properties of a Chinese questionnaire which assesses the barriers and enablers to commencing insulin in primary care patients with poorly controlled Type 2 diabetes. RESEARCH DESIGN AND METHOD: Questionnaire items were identified using literature review. Content validation was performed and items were further refined using an expert panel. Following translation, back translation and cognitive debriefing, the translated Chinese questionnaire was piloted on target patients. Exploratory factor analysis and item-scale correlations were performed to test the construct validity of the subscales and items. Internal reliability was tested by Cronbach's alpha. RESULTS: Twenty-seven identified items underwent content validation, translation and cognitive debriefing. The translated questionnaire was piloted on 303 insulin naïve (never taken insulin Type 2 diabetes patients recruited from 10 government-funded primary care clinics across Hong Kong. Sufficient variability in the dataset for factor analysis was confirmed by Bartlett's Test of Sphericity (P 0.4 and Eigenvalues >1. Total variance for the 10 factors was 66.22%. Kaiser-Meyer-Olkin measure was 0.725. Cronbach's alpha coefficients for the first four factors were ≥0.6 identifying four sub-scales to which 13 items correlated. Remaining sub-scales and items with poor internal reliability were deleted. The final 13-item instrument had a four scale structure addressing: 'Self-image and stigmatization'; 'Factors promoting self-efficacy; 'Fear of pain or needles'; and 'Time and family support'. CONCLUSION: The Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ appears to be a reliable and valid measure for assessing barriers to starting insulin. This short instrument is easy to administer and may be used by healthcare providers and researchers as an assessment tool for Chinese diabetic primary care patients, including the elderly, who are

Low body weight and type of protease inhibitor predict discontinuation and treatment-limiting adverse drug reactions among HIV-infected patients starting a protease inhibitor regimen: consistent results from a randomized trial and an observational cohort

DEFF Research Database (Denmark)

Kirk, O; Gerstoft, J; Pedersen, C

2001-01-01

OBJECTIVES: To assess predictors for discontinuation and treatment-limiting adverse drug reactions (TLADR) among patients starting their first protease inhibitor (PI). METHODS: Data on patients starting a PI regimen (indinavir, ritonavir, ritonavir/saquinavir and saquinavir hard gel) in a randomi......OBJECTIVES: To assess predictors for discontinuation and treatment-limiting adverse drug reactions (TLADR) among patients starting their first protease inhibitor (PI). METHODS: Data on patients starting a PI regimen (indinavir, ritonavir, ritonavir/saquinavir and saquinavir hard gel....... Low body weight and initiation of ritonavir relative to other PIs were associated with an increased risk of TLADRs. Very consistent results were found in a randomized trial and an observational cohort....

Is patient-centredness in European hospitals related to existing quality improvement strategies? Analysis of a cross-sectional survey (MARQuIS study)

NARCIS (Netherlands)

Groene, O.; Lombarts, M. J. M. H.; Klazinga, N.; Alonso, J.; Thompson, A.; Suñol, R.

2009-01-01

Background: There is growing recognition of patients' contributions to setting objectives for their own care, improving health outcomes and evaluating care. Objective: To quantify the extent to which European hospitals have implemented strategies to promote a patient-centred approach, and to assess

ETDR, The European Union's Experimental Gas-Cooled Fast Reactor Project

International Nuclear Information System (INIS)

Poette, Christian; Brun-Magaud, Valerie; Morin, Franck; Dor, Isabelle; Pignatel, Jean-Francois; Bertrand, Frederic; Stainsby, Richard; Pelloni, Sandro; Every, Denis; Da Cruz, Dirceu

2008-01-01

In the Gas-Cooled Fast Reactor (GFR) development plan, the Experimental Technology Demonstration Reactor (ETDR) is the first necessary step towards the electricity generating prototype GFR. It is a low power (∼50 MWth) Helium cooled fast reactor. The pre-conceptual design of the ETDR is shared between European partners through the GCFR Specifically Targeted Research Project (STREP) within the European Commission's 6. R and D Framework Program. After recalling the place of ETDR in the GFR development plan, the main reactor objectives, the role of the European partners in the different design and safety tasks, the paper will give an overview of the current design with recent progresses in various areas like: - Sub-assembly technology for the starting core (pin bundle with MOX fuel and stainless steel cladding). - The design of experimental advanced ceramic GFR fuel sub-assemblies included in several locations of the starting core. - Starting Core reactivity management studies model including experimental GFR sub-assemblies. - Neutron and radiation shielding calculations using a specific MCNP model. The model allows evaluation of the neutron doses for the vessel and internals and radiation doses for maintenance operations. - System design and safety considerations, with a reactor architecture largely influenced by the Decay Heat Removal strategy (DHR) for de-pressurized accidents. The design of the reactor raises a number of issues in terms of fuel, neutronics, thermal-hydraulics codes qualification as well as critical components (blowers, IHX, thermal barriers) qualification. An overview of the R and D development on codes and technology qualification program is presented. Finally, the status of international collaborations and their perspectives for the ETDR are mentioned. (authors)

EMSO: European multidisciplinary seafloor observatory

Science.gov (United States)

Favali, Paolo; Beranzoli, Laura

2009-04-01

EMSO has been identified by the ESFRI Report 2006 as one of the Research Infrastructures that European members and associated states are asked to develop in the next decades. It will be based on a European-scale network of multidisciplinary seafloor observatories from the Arctic to the Black Sea with the aim of long-term real-time monitoring of processes related to geosphere/biosphere/hydrosphere interactions. EMSO will enhance our understanding of processes, providing long time series data for the different phenomenon scales which constitute the new frontier for study of Earth interior, deep-sea biology and chemistry, and ocean processes. The development of an underwater network is based on past EU projects and is supported by several EU initiatives, such as the on-going ESONET-NoE, aimed at strengthening the ocean observatories' scientific and technological community. The EMSO development relies on the synergy between the scientific community and industry to improve European competitiveness with respect to countries such as USA, Canada and Japan. Within the FP7 Programme launched in 2006, a call for Preparatory Phase (PP) was issued in order to support the foundation of the legal and organisational entity in charge of building up and managing the infrastructure, and coordinating the financial effort among the countries. The EMSO-PP project, coordinated by the Italian INGV with participation by 11 institutions from as many European countries, started in April 2008 and will last four years.

Clinical audits: who does control what? European guide lines

International Nuclear Information System (INIS)

Jarvinen, H.

2009-01-01

The E.C. directive 97/43/EURATOM (M.E.D.-directive) introduced the concept of Clinical Audit for the assessment of medical radiological practices (diagnostic radiology, nuclear medicine and radiotherapy). The European Commission started in June 2007 a special project to review in detail the status of implementation of Clinical audits in Member States and to prepare European Guidance on Clinical Audits for diagnostic radiology, nuclear medicine and radiotherapy. The purpose of this E.C. project is to provide clear and comprehensive information and guidance on the procedures and criteria for clinical audits in all radiological practices, in order to improve the implementation of Article 6.4 of the M.E.D.-directive. The guidance should be flexible and enable the member States to adopt the model of clinical audit with respect to their national legislation and administrative provisions. By definition, clinical audit is a systematic examination or review of medical radiological procedures. It seeks to improve the quality and the outcome of patient care through structured review whereby radiological practices, procedures and results are examined against agreed standards for good medical radiological procedures. Modifications of the practices are implemented where indicated and new standards applied if necessary. The general objectives of clinical audit should be: to improve the quality of patient care, to promote the effective use of resources, to enhance the provision and organization of clinical services, to further professional education and training. Clinical audits must be at the same time internal (set by the management of the department) and external (set by external auditors at the department). It must not be confused with other evaluation activities such inspections, accreditation or quality system certifications. Clinical audits should address structure, process and outcome such the unit mission, quality assurance, dosimetry and treatments follow-up. The recent

Past and Current Paths to European Union Accession: Romania and Turkey a Comparative Approach

Directory of Open Access Journals (Sweden)

Tatiana-Camelia Dogaru

2015-05-01

Full Text Available Several decades ago, leaders of six European countries with an inclusive vision of Europe and strong courage started a construction without precedent, the European Union. The remarkable construction evolved not only concerning the number of the Member States, but also in terms of institutional and functional development. Nowadays, the European Union is one of the most important changing factor concerning the governance and the policy-making process at European level and not only, and there is no doubt that the EU will continue to grow as an increasing number of countries express interest in membership. This paper reveals in a comparative perspective the path to European Union Accession, and is based on documentary analysis, using strategy-level documents of the countries and the Progress Reports the European Commission provided during the past enlargement.

START (screening tool to alert doctors to the right treatment)--an evidence-based screening tool to detect prescribing omissions in elderly patients.

LENUS (Irish Health Repository)

Barry, P J

2012-02-03

BACKGROUND: Inappropriate prescribing encompasses acts of commission i.e. giving drugs that are contraindicated or unsuitable, and acts of omission i.e. failure to prescribe drugs when indicated due to ignorance of evidence base or other irrational basis e.g. ageism. There are considerable published data on the prevalence of inappropriate prescribing; however, there are no recent published data on the prevalence of acts of omission. The aim of this study was to calculate the prevalence of acts of prescribing omission in a population of consecutively hospitalised elderly people. METHODS: A screening tool (screening tool to alert doctors to the right treatment acronym, START), devised from evidence-based prescribing indicators and arranged according to physiological systems was prepared and validated for identifying prescribing omissions in older adults. Data on active medical problems and prescribed medicines were collected in 600 consecutive elderly patients admitted from the community with acute illness to a teaching hospital. On identification of an omitted medication, the patient\\'s medical records were studied to look for a valid reason for the prescribing omission. RESULTS: Using the START list, we found one or more prescribing omissions in 57.9% of patients. In order of prevalence, the most common prescribing omissions were: statins in atherosclerotic disease (26%), warfarin in chronic atrial fibrillation (9.5%), anti-platelet therapy in arterial disease (7.3%) and calcium\\/vitamin D supplementation in symptomatic osteoporosis (6%). CONCLUSION: Failure to prescribe appropriate medicines is a highly prevalent problem among older people presenting to hospital with acute illness. A validated screening tool (START) is one method of systematically identifying appropriate omitted medicines in clinical practice.

European indoor air quality audit project in 56 office buildings

NARCIS (Netherlands)

Bluyssen, P.M.; Oliveira Fernandes, E. de; Groes, L.; Clausen, G.H.; Fanger, F.O.; Valbjorn, O.; Bernhard, C.A.; Roulet, C.A.

1996-01-01

A European project started at the end of 1992, in which, in addition to current methods, trained sensory panels were used to investigate office buildings all over Europe. The main aim of this EC-Audit was to develop assessment procedures and guid-ance on ventilation and source control, to help

Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC)

DEFF Research Database (Denmark)

Flotats, Albert; Gutberlet, Matthias; Knuuti, Juhani

2011-01-01

. The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients...

Vaccination in paediatric patients with auto-immune rheumatic diseases : A systemic literature review for the European League against Rheumatism evidence-based recommendations

NARCIS (Netherlands)

Heijstek, M. W.; de Bruin, L. M. Ott; Borrow, R.; van der Klis, F.; Kone-Paut, I.; Fasth, A.; Minden, K.; Ravelli, A.; Abinun, M.; Pileggi, G.; Borte, M.; Bijl, M.; Wulffraat, N. M.

2011-01-01

Objectives: To analyze available evidence on vaccinations in paediatric patients with rheumatic and auto-inflammatory diseases. This evidence formed the basis of the recently constructed European League against Rheumatism (EULAR) recommendations for vaccination of these patients. Methods: A

High Tech Start-Ups in Europe : The Effect of Regulatory Competition on the Emergence of New Business Forms

NARCIS (Netherlands)

McCahery, J.A.; Vermeulen, E.P.M.

2001-01-01

This paper will examine the theoretical arguments for and against the importance of new business forms for the growth of start-ups. Part I briefly reviews the recent history of business organisational law and reform within Europe. Our review of extant European business forms reveals that the absence

Potential formula for the calculation of starting and incremental insulin glargine doses: ALOHA subanalysis.

Directory of Open Access Journals (Sweden)

Takashi Kadowaki

Full Text Available BACKGROUND: Pragmatic methods for dose optimization are required for the successful basal management in daily clinical practice. To derive a useful formula for calculating recommended glargine doses, we analyzed data from the Add-on Lantus® to Oral Hypoglycemic Agents (ALOHA study, a 24-week observation of Japanese type 2 diabetes patients. METHODOLOGY/PRINCIPAL FINDINGS: The patients who initiated insulin glargine in basal-supported oral therapy (BOT regimen (n = 3506 were analyzed. The correlations between average changes in glargine dose and HbA1c were calculated, and its regression formula was estimated from grouped data categorized by baseline HbA1c levels. Starting doses of the background-subgroup achieving the HbA1c target with a last-observed dose above the average were compared to an assumed optimal starting dose of 0.15 U/kg/day. The difference in regression lines between background-subgroups was examined. A formula for determining the optimal starting and titration doses was thereby derived. The correlation coefficient between changes in dose and HbA1c was -0.9043. The estimated regression line formula was -0.964 × change in HbA1c+2.000. A starting dose of 0.15 U/kg/day was applicable to all background-subgroups except for patients with retinopathy (0.120 U/kg/day and/or with eGFR<60 mL/min/1.73 m(2 (0.114 U/kg/day. Additionally, women (0.135 U/kg/day and patients with sulfonylureas (0.132 U/kg/day received a slightly decreased starting dose. CONCLUSIONS/SIGNIFICANCE: We suggest a simplified and pragmatic dose calculation formula for type 2 diabetes patients starting glargine BOT optimal daily dose at 24 weeks  =  starting dose (0.15×weight + incremental dose (baseline HbA1c - target HbA1c+2. This formula should be further validated using other samples in a prospective follow-up, especially since several patient groups required lower starting doses.

The european programme on negative ion beam development

International Nuclear Information System (INIS)

Pamela, J.; Hemsworth, R.; Jacquot, C.; Holmes, A.J.T.

1991-01-01

The European Programme on Negative Ion Beam development consists presently of three main tasks: (i) the DRAGON experiment starting at Culham, with the objective of accelerating 4 A of D - to 200 keV; (ii) the conceptual study of a 1 MV, 15 A power supply, conducted in european industry under the supervision of Cadarache; (iii) the design study of a 1MV, 4 A, deuterium test bed at Cadarache, conducted by the EURATOM-CEA Association (Cadarache) with support from the EURATOM-UKAEA association (Culham) and the FOM institute (Amsterdam). The conclusions of these three tasks are to be brought together during the first half of 1992, in order to prepare a proposal for a 1 MV, 4 A, deuterium test bed. Other experimental activities are being conducted in european laboratories, either directly related to the main programme (RF source and plasma neutralizer at Culham; discharge pulsing at Dublin and FOM-Amsterdam) or under separate contracts (energy recovery and cesium seeding at Cadarache)

The European network of Biosafety-Level-4 laboratories: enhancing European preparedness for new health threats.

Science.gov (United States)

Nisii, C; Castilletti, C; Di Caro, A; Capobianchi, M R; Brown, D; Lloyd, G; Gunther, S; Lundkvist, A; Pletschette, M; Ippolito, G

2009-08-01

Emerging and re-emerging infections and possible bioterrorism acts will continue to challenge both the medical community and civilian populations worldwide, urging health authorities to respond rapidly and effectively. Established in 2005, the European Community (EC)-funded European Network of Biosafety-Level-4 laboratories (Euronet-P4), which brings together the laboratories in Porton Down, London, Hamburg, Marburg, Solna, Lyon and Rome, seeks to increase international collaboration in the areas of high containment laboratory biosafety and viral diagnostic capability, to strengthen Europe's capacity to respond to an infectious disease emergency, and to offer assistance to countries not equipped with such costly facilities. Network partners have agreed on a common strategy to fill the gaps identified in the field of risk group-4 agents' laboratory diagnosis, namely the lack of standardization and of reference samples. The network has received a further 3-year funding, to offer assistance to external laboratories, and to start the planning of field activities.

European road users’ risk perception and mobility : the SARTRE 4 survey.

NARCIS (Netherlands)

Antov, D. Banet, A. Barbier, C. Bellet, T. Bimpeh, Y. Boulanger, A. Brandstätter, C. Britschgi, V. Brosnan, M. Buttler, I. Cestac, J. , De Craen, S. de Delhomme, P. Dogan, E. Drápela, E. Forward, S. Freeman, R. Furian, G. Gábor, M. Goldenbeld, C. Henriksson, P. Holte, H. Kraïem, S. Papadimitriou, E. Podlesek, A. Polic, M. Sánchez-Martín, F. Sardi, G.-M. Schmidt, E.-A. Silverans, P. Siska, T. Skládaná, P. Theofilatos, A. Below, A. von Yannis, G. Zaidel, D. & Zavrides, N.

2012-01-01

The SARTRE (Social Attitudes to Road Traffic Risk in Europe) project started in 1991. It consists of a European wide survey about knowledge of road traffic laws and road traffic risks, attitudes regarding road safety issues, reported road traffic behaviours, transport habits and needs in several

Medical and biological progress and the European Convention on Human Rights.

Science.gov (United States)

Byk, C

1992-01-01

The advances made in life sciences are one of the most significant features of the 20th century scientific revolution and human rights obviously enjoy prominence among the legal issues affected by the development of medicine. The case law of the organs of the European Convention on Human Rights arising from developments in the biomedical sciences is reviewed. The approach of especially the European Commission on Human Rights to the consequences of advances in the life sciences on the protection of the individual's physical integrity and the protection of freedom of thought and private and family life is analysed. 'Contrary to what we are led to believe, it is not from the starting-point of biology that a particular idea of man can be formed; on the contrary, it is from the starting-point of a particular idea of man that biology can be used to serve him': F Gros, F Jacob & P Royer Life Sciences and Society (1979) 288.

Boron Neutron Capture Therapy at European research reactors - Status and perspectives

International Nuclear Information System (INIS)

Moss, R.L.

2004-01-01

Over the last decade. there has been a significant revival in the development of Boron Neutron Capture Therapy (BNCT) as a treatment modality for curing cancerous tumours, especially glioblastoma multiforme and subcutaneous malignant melanoma. In 1987 a European Collaboration on BNCT was formed, with the prime task to identify suitable research reactors in Europe where BNCT could be applied. Due to reasons discussed in this paper, the HFR Petten was chosen as the test-bed for demonstrating BNCT. Currently, the European Collaboration is approaching the start of clinical trials, using epithermal neutrons and borocaptate sodium (BSH) as the 10 B delivery agent. The treatment is planned to start in the first half of 1996. The paper here presents an overview on the principle of BNCT, the requirements imposed on a research reactor in order to be considered for BNCT, and the perspectives for other European materials testing reactors. A brief summary on the current status of the work at Petten is given, including: the design, construction and characterisation of the epithermal neutron beam: performance and results of the healthy tissue tolerance study; the development of a treatment planning programme based on the Monte Carlo code MCNP; the design of an irradiation room; and on the clinical trials themselves. (author)

Management and follow-up of gallbladder polyps : Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE).

Science.gov (United States)

Wiles, Rebecca; Thoeni, Ruedi F; Barbu, Sorin Traian; Vashist, Yogesh K; Rafaelsen, Søren Rafael; Dewhurst, Catherine; Arvanitakis, Marianna; Lahaye, Max; Soltes, Marek; Perinel, Julie; Roberts, Stuart Ashley

2017-09-01

The management of incidentally detected gallbladder polyps on radiological examinations is contentious. The incidental radiological finding of a gallbladder polyp can therefore be problematic for the radiologist and the clinician who referred the patient for the radiological examination. To address this a joint guideline was created by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE). A targeted literature search was performed and consensus guidelines were created using a series of Delphi questionnaires and a seven-point Likert scale. A total of three Delphi rounds were performed. Consensus regarding which patients should have cholecystectomy, which patients should have ultrasound follow-up and the nature and duration of that follow-up was established. The full recommendations as well as a summary algorithm are provided. These expert consensus recommendations can be used as guidance when a gallbladder polyp is encountered in clinical practice. • Management of gallbladder polyps is contentious • Cholecystectomy is recommended for gallbladder polyps >10 mm • Management of polyps <10 mm depends on patient and polyp characteristics • Further research is required to determine optimal management of gallbladder polyps.

Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain

DEFF Research Database (Denmark)

Kongsted, Alice; Johannesen, Else; Leboeuf-Yde, Charlotte

2011-01-01

The STarT back screening tool (SBT) allocates low back pain (LBP) patients into three risk groups and is intended to assist clinicians in their decisions about choice of treatment. The tool consists of domains from larger questionnaires that previously have been shown to be predictive of non-reco...

Why START?

International Nuclear Information System (INIS)

Mendelsohn, J.

1991-01-01

Barring some major unexpected downturn in US-Soviet relations, it seems likely that the long-awaited Strategic Arms Reduction Talks (START) treaty will be signed sometime in 1991. Under negotiation for the past nine years, public acceptance and Senate approval of a START treaty will be facilitated by the generally less confrontational East-West relationship which has evolved over that time, by the growing constraints on the US defense budget, and by the obvious merits of the treaty itself. Not only will the nearly complete START treaty be an extremely useful and powerful arms control agreement, it is also decidedly advantageous to US security interests. First and foremost, a START treaty will cap and reduce the steady buildup of nuclear weapons that has characterized the last 30 years of the US-Soviet strategic relationship. As a result of the basic outline originally agreed to at the Reykjavik summit, START will take a 25 to 35 percent bite out of existing nuclear arsenals, impose approximately a 50 percent cut in overall Soviet ballistic missile warheads and throw-weight (lifting power or payload capacity), and produce an exact 50 percent cut in Soviet SS-18 missiles

European Society of Endocrinology Clinical Practice Guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma.

Science.gov (United States)

Plouin, P F; Amar, L; Dekkers, O M; Fassnacht, M; Gimenez-Roqueplo, A P; Lenders, J W M; Lussey-Lepoutre, C; Steichen, O

2016-05-01

Phaeochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumours. Standard treatment is surgical resection. Following complete resection of the primary tumour, patients with PPGL are at risk of developing new tumoural events. The present guideline aims to propose standardised clinical care of long-term follow-up in patients operated on for a PPGL. The guideline has been developed by The European Society of Endocrinology and based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles. We performed a systematic review of the literature and analysed the European Network for the Study of Adrenal Tumours (ENS@T) database. The risk of new events persisted in the long term and was higher for patients with genetic or syndromic diseases. Follow-up in the published cohorts and in the ENS@T database was neither standardised nor exhaustive, resulting in a risk of follow-up bias and in low statistical power beyond 10 years after complete surgery. To inform patients and care providers in this context of low-quality evidence, the Guideline Working Group therefore prepared recommendations on the basis of expert consensus. Key recommendations are the following: we recommend that all patients with PPGL be considered for genetic testing; we recommend assaying plasma or urinary metanephrines every year to screen for local or metastatic recurrences or new tumours; and we suggest follow-up for at least 10 years in all patients operated on for a PPGL. High-risk patients (young patients and those with a genetic disease, a large tumour and/or a paraganglioma) should be offered lifelong annual follow-up. © 2016 European Society of Endocrinology.

European Commission research on aircraft impacts in the atmosphere

Energy Technology Data Exchange (ETDEWEB)

Amanatidis, G T; Angeletti, G [European Commission (CEC), Brussels (Belgium)

1998-12-31

Aircraft engines release in the troposphere and lower stratosphere a number of chemical compounds (NO{sub x}, CO{sub 2}, CO, H{sub 2}O, hydrocarbons, sulphur, soot, etc.) which could potentially affect the ozone layer and the climate through chemical, dynamical and radiative changes. The global amount of gases and particles emitted by current subsonic and projected supersonic aircraft fleets can be estimated, but significant uncertainties remain about the fate of these emissions in the atmosphere. The European efforts concerning these potential atmospheric impacts of aircraft emissions are conducted by the Environment and Climate Research Programme of the European Commission (EC) as well as by national programmes of the Member States of the European Union (EU). The European research activities in this field, are described, divided for practical reasons in two periods. The first includes activities supported under the 3. Framework Programme for R and D activities which covered the period from 1992 up to 1996, while the second period has started in early 1996 and is supported under the 4. Framework Programme. (R.P.) 6 refs.

European Commission research on aircraft impacts in the atmosphere

Energy Technology Data Exchange (ETDEWEB)

Amanatidis, G.T.; Angeletti, G. [European Commission (CEC), Brussels (Belgium)

1997-12-31

Aircraft engines release in the troposphere and lower stratosphere a number of chemical compounds (NO{sub x}, CO{sub 2}, CO, H{sub 2}O, hydrocarbons, sulphur, soot, etc.) which could potentially affect the ozone layer and the climate through chemical, dynamical and radiative changes. The global amount of gases and particles emitted by current subsonic and projected supersonic aircraft fleets can be estimated, but significant uncertainties remain about the fate of these emissions in the atmosphere. The European efforts concerning these potential atmospheric impacts of aircraft emissions are conducted by the Environment and Climate Research Programme of the European Commission (EC) as well as by national programmes of the Member States of the European Union (EU). The European research activities in this field, are described, divided for practical reasons in two periods. The first includes activities supported under the 3. Framework Programme for R and D activities which covered the period from 1992 up to 1996, while the second period has started in early 1996 and is supported under the 4. Framework Programme. (R.P.) 6 refs.

European Union security policy through strategic culture

Directory of Open Access Journals (Sweden)

Beriša Hatidža

2014-01-01

Full Text Available In this paper, we shall pay attention to the security policy of the European Union, through the strategic culture, starting from the existing various options for cooperation in the field of security and defense. Our goal is to look at the implementation of the Strategic Culture of the European Union (EU SK, research ways to improve the international position of the Union and its impact on policy cooperation and trust with other collectives. Analysis of flexible cooperation between the European Union, as well as access to special procedures in the field of security and defense policy, we will follow the ambition and capacity in implementing the same. Paper aims to introduce the idea of the European Union, which allows its members to rationally consider and check the box of options available to decision makers. In this regard, the EU seeks to build its own armed forces to protect the association of interests-investment terms. Reviewing and understanding the strategic culture of the EU by countries that are not its members can be seen as reasons for strengthening the capacity of the Union for the realization of the impact of the global security as well as predicting its future steps.

ACCOUNTING OF AGRICULTURAL ACTIVITIES AND EUROPEAN FUNDS

Directory of Open Access Journals (Sweden)

Daniel Petru VARTEIU

2017-12-01

Full Text Available The economical operations developed by the beneficiaries of European funds projects, are registered in accounting, based on justifying documents, in accordance with the national and international legislation in effect. The beneficiaries of European funds projects may be organized starting from the simplest form of organisation, which takes the form of self – employed person (SEP till the most complex form of organisation such as trading companies (T.C.. The Romanian institutions which finance agricultural activities are Ministry of Agriculture and Rural Development (M.A.R.D which subordinates Rural Investment Finance Agency (R.I.F.A and Payment and Intervention Agency in Agriculture (P.I.A.A. The Ministry of Agriculture and Rural Development has an authority role, of management (AM for the National Rural Development Program (N.R.D.P and for the Fisheries Operational Program (F.O.P. The funds obtained from the European Union and from Romanian institutions for the development of agricultural activities are registered in accounting as grants, in the category of grants afferent to assets or afferent to incomes.

From Head Start to Sure Start: Reflections on Policy Transfer

Science.gov (United States)

Welshman, John

2010-01-01

This article uses the history of debates over the US Head Start programme (1965), Early Head Start (1994) and the UK Sure Start initiative (1998), as a window on to policy transfer. In all the three, the aim was that early intervention could offer a means of boosting children's educational attainment and of countering the wider effects of poverty…

Comparison of single and boosted protease inhibitor versus nonnucleoside reverse transcriptase inhibitor-containing cART regimens in antiretroviral-naïve patients starting cART after January 1, 2000

DEFF Research Database (Denmark)

Mocroft, A; Horban, A; Clumeck, N

2006-01-01

increase) response in antiretroviral-naïve patients starting either a single protease inhibitor (PI; n = 183), a ritonavir-boosted PI regimen (n = 197), or a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based cART regimen (n = 447) after January 1, 2000, and the odds of lack of virologic...... or immunologic response at 3 years after starting cART. METHOD: Cox proportional hazards models and logistic regression. RESULTS: After adjustment, compared to patients taking an NNRTI-regimen, patients taking a single-PI regimen were significantly less likely to achieve a viral load (VL)

Towards cooperation between European start ups : the position of the French, Dutch, and German entrepreneurial and innovative engineer

OpenAIRE

Ulijn, J.M.; Fayolle, A.

2002-01-01

People who want to start their own business often try to survive or to die again on their own. The very fact that "others", apart from family, friends and fools who invest in their venture, are quickly seen as probable competitors, who want the steal the idea, prevent start ups from cooperation with partners. Setting up a personal network might even cause more risk, since one has to share ideas for technological development of the idea or look for a market for it. The consequence is that with...

The European Citizens’ Initiative: Transnational Democracy in the EU at last?

Directory of Open Access Journals (Sweden)

Maximilian Conrad

2011-06-01

Full Text Available The European Union’s Lisbon Treaty, in force since December 2009, introduced the European Citizens’ Initiative (ECI as a means of strengthening citizen involvement in EU decision making. A minimum of one million citizens from at least seven of the EU’s current 27 member states can request that the European Commission submit a legislative proposal on the issue of the initiative. But the ECI is not only a means of strengthening participatory democracy in the EU. It also bears the potential for a more fundamental transformation of democracy, namely in the direction of transnational participatory democracy. Starting with a short introduction to how the ECI will work in practice as well as a brief history of participatory democracy in the EU, this article therefore examines the ECI from the perspective of democratic theory. How profound an impact will the ECI have on democracy in the European Union?

Comparison of perceived barriers to entrepreneurship in Eastern and Western European countries

NARCIS (Netherlands)

Iakovleva, T.A.; Kolvereid, L.; M.J. Gorgievski-Duijvesteijn (Marjan); Sørhaug, Ø

2014-01-01

textabstractThis qualitative study among 591 business students from four European countries investigated cross-country differences in the kind of barriers people perceive to business start-up. In line with institutional theory, the most important perceived barriers in all countries related to

Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe - analyses of the European Surveillance System on Contact Allergy network, 2002-2010.

Science.gov (United States)

Pesonen, Maria; Jolanki, Riitta; Larese Filon, Francesca; Wilkinson, Mark; Kręcisz, Beata; Kieć-Świerczyńska, Marta; Bauer, Andrea; Mahler, Vera; John, Swen M; Schnuch, Axel; Uter, Wolfgang

2015-03-01

Occupational contact dermatitis is one of the most common occupational diseases in Europe. In order to develop effective preventive measures, detailed and up-to-date data on the incidence, main causes and professions at risk of occupational contact dermatitis are needed. To describe the pattern of patch test reactivity to allergens in the European baseline series of patients with occupational contact dermatitis in different occupations. We analysed data collected by the European Surveillance System on Contact Allergy (ESSCA) network from 2002 to 2010, from 11 European countries. Allergens in the European baseline series associated with an at least doubled risk of occupational contact dermatitis include: thiuram rubber chemical accelerators, epoxy resin, and the antimicrobials methylchloroisothiazolinone/methylisothiazolinone, methyldibromo glutaronitrile, and formaldehyde. The highest risk of occupational contact dermatitis was found in occupations classified as 'other personal services workers', which includes hairdressers, nursing and other healthcare professionals, precision workers in metal and related materials, and blacksmiths, tool-makers and related trades workers. In the planning and implementation of measures aimed at preventing occupational contact dermatitis, the focus should be on the identified high-risk occupational groups and the most common occupational allergies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Joint Efforts Towards European HF Radar Integration

Science.gov (United States)

Rubio, A.; Mader, J.; Griffa, A.; Mantovani, C.; Corgnati, L.; Novellino, A.; Schulz-Stellenfleth, J.; Quentin, C.; Wyatt, L.; Ruiz, M. I.; Lorente, P.; Hartnett, M.; Gorringe, P.

2016-12-01

During the past two years, significant steps have been made in Europe for achieving the needed accessibility to High Frequency Radar (HFR) data for a pan-European use. Since 2015, EuroGOOS Ocean Observing Task Teams (TT), such as HFR TT, are operational networks of observing platforms. The main goal is on the harmonization of systems requirements, systems design, data quality, improvement and proof of the readiness and standardization of HFR data access and tools. Particular attention is being paid by HFR TT to converge from different projects and programs toward those common objectives. First, JERICO-NEXT (Joint European Research Infrastructure network for Coastal Observatory - Novel European eXpertise for coastal observaTories, H2020 2015 Programme) will contribute on describing the status of the European network, on seeking harmonization through exchange of best practices and standardization, on developing and giving access to quality control procedures and new products, and finally on demonstrating the use of such technology in the general scientific strategy focused by the Coastal Observatory. Then, EMODnet (European Marine Observation and Data Network) Physics started to assemble HF radar metadata and data products within Europe in a uniform way. This long term program is providing a combined array of services and functionalities to users for obtaining free of charge data, meta-data and data products on the physical conditions of European sea basins and oceans. Additionally, the Copernicus Marine Environment Monitoring Service (CMEMS) delivers from 2015 a core information service to any user related to 4 areas of benefits: Maritime Safety, Coastal and Marine Environment, Marine Resources, and Weather, Seasonal Forecasting and Climate activities. INCREASE (Innovation and Networking for the integration of Coastal Radars into EuropeAn marine SErvices - CMEMS Service Evolution 2016) will set the necessary developments towards the integration of existing European

EURECCA colorectal: multidisciplinary management: European consensus conference colon & rectum.

Science.gov (United States)

van de Velde, Cornelis J H; Boelens, Petra G; Borras, Josep M; Coebergh, Jan-Willem; Cervantes, Andres; Blomqvist, Lennart; Beets-Tan, Regina G H; van den Broek, Colette B M; Brown, Gina; Van Cutsem, Eric; Espin, Eloy; Haustermans, Karin; Glimelius, Bengt; Iversen, Lene H; van Krieken, J Han; Marijnen, Corrie A M; Henning, Geoffrey; Gore-Booth, Jola; Meldolesi, Elisa; Mroczkowski, Pawel; Nagtegaal, Iris; Naredi, Peter; Ortiz, Hector; Påhlman, Lars; Quirke, Philip; Rödel, Claus; Roth, Arnaud; Rutten, Harm; Schmoll, Hans J; Smith, Jason J; Tanis, Pieter J; Taylor, Claire; Wibe, Arne; Wiggers, Theo; Gambacorta, Maria A; Aristei, Cynthia; Valentini, Vincenzo

2014-01-01

Care for patients with colon and rectal cancer has improved in the last 20years; however considerable variation still exists in cancer management and outcome between European countries. Large variation is also apparent between national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which is the acronym of European Registration of Cancer Care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012, the first multidisciplinary consensus conference about cancer of the colon and rectum was held. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Consensus was achieved using the Delphi method. For the Delphi process, multidisciplinary experts were invited to comment and vote three web-based online voting rounds and to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. This manuscript covers all sentences of the consensus document with the result of the voting. The consensus document represents sections on diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where

USABC Development of 12 Volt Battery for Start-Stop Application: Preprint

Energy Technology Data Exchange (ETDEWEB)

Tataria, H.; Gross, O.; Bae, C.; Cunningham, B.; Barnes, J. A.; Deppe, J.; Neubauer, J.

2015-02-01

Global automakers are accelerating the development of fuel efficient vehicles, as a part of meeting regional regulatory CO2 emissions requirements. The micro hybrid vehicles with auto start-stop functionality are considered economical solutions for the stringent European regulations. Flooded lead acid batteries were initially considered the most economical solution for idle-stop systems. However, the dynamic charge acceptance (DCA) at lower state-of-charge (SOC) was limiting the life of the batteries. While improved lead-acid batteries with AGM and VRLA features have improved battery longevity, they do not last the life of the vehicle. The United States Advanced Battery Consortium (or USABC, a consortium of GM, Ford, and Chrysler) analyzed energy storage needs for a micro hybrid automobile with start-stop capability, and with a single power source. USABC has analyzed the start-stop behaviors of many drivers and has developed the requirements for the start-stop batteries (Table 3). The testing procedures to validate the performance and longevity were standardized and published. The guideline for the cost estimates calculations have also been provided, in order to determine the value of the newly developed modules. The analysis effort resulted in a set of requirements which will help the battery manufacturers to develop a module to meet the automotive Original Equipment Manufacturers (OEM) micro hybrid vehicle requirements. Battery developers were invited to submit development proposals and two proposals were selected for 50% cost share with USABC/DOE.

European symposium on precision medicine in allergy and airways diseases

DEFF Research Database (Denmark)

Muraro, A; Fokkens, W J; Pietikainen, S

2015-01-01

David Borrelli and with active participation of the European Respiratory Society (ERS), the European Federations of Allergy and Airways Diseases Patients Associations (EFA), the Global Allergy and Asthma European Network (Ga2len), Allergic Rhinitis and Its Impact on Asthma (ARIA) and the Respiratory....... This report summarizes the key messages delivered during the symposium by the speakers, including the EU Commissioner for Health and Food Safety Vitenys Andriukaitis. The Commissioner underscored the need for optimal patient care in Europe, supporting joint action plans for disease prevention, patient...... the epidemic of Allergy and Asthma in Europe. The socio-economic impact of allergies and chronic airways diseases cannot be underestimated, as they represent the most frequently diagnosed chronic non-communicable diseases in the EU. Despite the fact that 30% of the total European population is nowadays...

[Cross-cultural adaptation to the European Portuguese of the questionnaire "Patient Knowledge about their Medications" (CPM-ES-ES)].

Science.gov (United States)

Salmerón Rubio, Joaquín; Iglésias-Ferreira, Paula; García Delgado, Pilar; Mateus-Santos, Henrique; Martínez-Martínez, Fernando

2013-12-01

The scope of this work is to conduct the cross-cultural adaptation from Spanish to European Portuguese of a questionnaire to measure the degree of "Patient Knowledge about their Medications" (CPM-ES-ES). A method based on six steps was applied: 1. Translation into Portuguese, 2. Elaboration of the first consensus version in Portuguese; 3.Back-translation into Spanish; 4. Elaboration of the second consensus version (cultural equivalency); 5. Conducting the pre-test; 6. Evaluation of the overall results. A cross-culturally adapted questionnaire in European Portuguese that measures the degree of "Patient Knowledge about their Medications" is proposed. The pre-test confirmation obtained 100% agreement with the corrected version of the second consensus version after pre-testing. The methodology selected made it possible to cross-culturally adapt the Spanish version of the CPM-ES-ES questionnaire to the Portuguese version. Further studies should demonstrate the equivalence of the psychometric properties of the cross-cultural translation into Portuguese with the original version.

Quality of life in patients on chronic dialysis: self-assessment 3 months after the start of treatment. The Necosad Study Group

NARCIS (Netherlands)

Merkus, M. P.; Jager, K. J.; Dekker, F. W.; Boeschoten, E. W.; Stevens, P.; Krediet, R. T.

1997-01-01

The aim of the present multicenter study was to assess quality of life of Dutch dialysis patients 3 months after the start of chronic dialysis treatment. The quality of life was compared with the quality of life of a general population sample, and the impact of demographic, clinical, renal function,

Radiation therapy of Graves' ophthalmopathy. 2; Therapy started time

Energy Technology Data Exchange (ETDEWEB)

Kawamura, Toshinori; Koga, Sukehiko (Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine)

1994-04-01

The difference in the improvement of exophthalmos according to the period of starting radiation therapy was investigated for 26 patients of thyroid ophthalmopathy, also taking thyroidism during radiation into consideration. A 4 MV X-ray was used to a total dose of 20 Gy per 2 weeks. The treatment value tended to be better for the patients in whom the period from the appearance of exophthalmos in an euthyroid condition to the start of radiation was less than 12 months; those of a longer period showed poorer improvement. Radiation treatment of a hyperthyroid condition also showed poor results and it was thought it was not an adequately long enough period for the radiation to take effect. As a result, it was considered that the radiation therapy shall be advantageous if started within 12 months after the appearance of exophthalmos in an euthyroid condition. (author).

Promoting and Protecting Public Health: How the European Union Pharmacovigilance System Works.

Science.gov (United States)

Santoro, Aniello; Genov, Georgy; Spooner, Almath; Raine, June; Arlett, Peter

2017-10-01

This article provides an overview of the European Union pharmacovigilance system resulting from the rationalisation and strengthening delivered through the implementation of the revised pharmacovigilance legislation. It outlines the system aims, underlying principles, components and drivers for future change. At its core, the Pharmacovigilance Risk Assessment Committee is responsible for assessing all aspects of the risk management of medicinal products, thus ensuring that medicines approved for the European Union market are optimally used by maximising their benefits and minimising risks. The main objectives of the system are to promote and protect public health by supporting the availability of medicines including those that fulfil previously unmet medical needs, and reducing the burden of adverse drug reactions. These are achieved through a proactive, risk proportionate and patient-centred approach, with high levels of transparency and engagement of civil society. In the European Union, pharmacovigilance is now fully integrated into the life cycle of medicinal products, with the planning of pharmacovigilance activities commencing before a medicine is placed on the market, and companies encouraged to start planning very early in development for high-innovation products. After authorisation, information on the safety of medicines continues to be obtained through a variety of sources, including spontaneous reports of adverse drug reactions or monitoring real-world data. Finally, the measurement of the impact of pharmacovigilance activities, auditing and inspections, as well as capacity building ensure that the system undergoes continuous improvement and can always rely on the best methodologies to safeguard public health.

Urgent-Start Peritoneal Dialysis Complications: Prevalence and Risk Factors.

Science.gov (United States)

Xu, Damin; Liu, Tianjiao; Dong, Jie

2017-07-01

Mechanical complications are of particular concern in urgent-start peritoneal dialysis (PD) because of the shorter break-in period. However, risk factors have been reported inconsistently and data in urgent-start PD populations are limited. Observational cohort study. All patients treated with urgent-start PD, defined as PD therapy initiated within 1 week after catheter insertion, January 2003 to May 2013. Age, sex, abdominal surgery history, body mass index, hemoglobin level, albumin level, C-reactive protein level, break-in period (period between catheter insertion and PD therapy initiation), dialysate exchange volume, and use of overnight dwell. The presence of mechanical complications related to abdominal wall or catheter, including hernia, hydrothorax, hydrocele, subcutaneous leak, pericatheter leak, catheter malposition, omental wrap, and obstruction. 922 patients on urgent-start PD therapy were enrolled (mean age, 59.1±15.0 [SD] years). Prevalences of abdominal wall and catheter complications were 4.8% and 9.5%, respectively. The most common abdominal wall complication was hernia (55%), followed by hydrothorax (25%). On adjustment, male sex (HR, 5.41; 95% CI, 2.15-13.59; Pstart PD and conventional PD. Urgent-start PD is a safe and practicable approach. Male sex and history of abdominal surgery could contribute to the development of abdominal wall complications. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Ethnic Group Differences in Early Head Start Parents Parenting Beliefs and Practices and Links to Children's Early Cognitive Development

Science.gov (United States)

Keels, Micere

2009-01-01

Data from the Early Head Start Research and Evaluation study were used to examine the extent to which several factors mediate between- and within-ethnic-group differences in parenting beliefs and behaviors, and children's early cognitive development (analysis sample of 1198 families). The findings indicate that Hispanic-, European-, and…

Characterization of patients diagnosed with central precocious puberty starting treatment with leuprolide acetate, at the Hospital Nacional de Ninos in the period January 2004 to December 2009

International Nuclear Information System (INIS)

Viquez Viquez, Natalia

2013-01-01

Clinical characteristics and laboratory and cabinet findings (hormone levels, bone age, pelvic ultrasound) were determined in a sample of 39 patients diagnosed with central precocious puberty (CPP) who started treatment with leuprolide acetate (LPA). The cross-sectional observational study was developed at the Hospital Nacional de Ninos 'Dr. Carlos Saenz Herrera' during the period 2004 and 2009. The chronological age of patients with CPP was specified at the time of diagnosis and to start treatment with LPA. Epidemiological characteristics (sex, origin) were described in patients with CPP. Bone age with respect to chronological age was identified in patients with CPP. Sexual maturity of patients with CPP was established by the Tanner scale. The hormone levels of estrogen, testosterone, luteinizing hormone and follicle stimulating hormone were specified in patients with CPP. The etiology was determined in patients with CPP treated with LPA. The adverse effects of treatment with LPA were described. Anthropometric measurements were detailed. The heredo-familial antecedents of precocious puberty were established in patients with diagnosis of CPP. The size of the pelvic organs was evaluated by pelvic ultrasound [es

Piloting the European Unified Patient Identity Management (EUPID) Concept to Facilitate Secondary Use of Neuroblastoma Data from Clinical Trials and Biobanking.

Science.gov (United States)

Ebner, Hubert; Hayn, Dieter; Falgenhauer, Markus; Nitzlnader, Michael; Schleiermacher, Gudrun; Haupt, Riccardo; Erminio, Giovanni; Defferrari, Raffaella; Mazzocco, Katia; Kohler, Jan; Tonini, Gian Paolo; Ladenstein, Ruth; Schreier, Guenter

2016-01-01

Data from two contexts, i.e. the European Unresectable Neuroblastoma (EUNB) clinical trial and results from comparative genomic hybridisation (CGH) analyses from corresponding tumour samples shall be provided to existing repositories for secondary use. Utilizing the European Unified Patient IDentity Management (EUPID) as developed in the course of the ENCCA project, the following processes were applied to the data: standardization (providing interoperability), pseudonymization (generating distinct but linkable pseudonyms for both contexts), and linking both data sources. The applied procedures resulted in a joined dataset that did not contain any identifiers that would allow to backtrack the records to either data sources. This provided a high degree of privacy to the involved patients as required by data protection regulations, without preventing proper analysis.

Electronic signatures and their specificity in national and European regulations

Directory of Open Access Journals (Sweden)

R. MATEFI

2017-07-01

Full Text Available The paper aims to emphasize the particularities of the electronic signature by reference to the national as well as to the European legislation, trying to point out its utility in the business environment as well as the controversies in this matter. The starting point of this analysis was the Directive 1999/93/EC of the European Parliament and of the Council of 13 December 1999 on a Community framework for electronic signatures, which establishes the legal framework for electronic signatures and the recognition of certification-service providers. Its main aim was to ease its use and help it become legally recognized within all EU countries.

THE "E TRIANGLE": EMPLOYMENT, EMPLOYEE AND EMPLOYER IN THE EUROPEAN UNION

Directory of Open Access Journals (Sweden)

Liviana Andreea Niminet

2016-06-01

Full Text Available One of the biggest forces of the European Union is its people, people living and working within this Union. This stands not only for the European Union but for every state, as it is well known that people are the ones that can make a state great or poor. For this reason, the matters regarding labor are a continuous concern both for European Union common institutions as well as for every individual state of the European Union. The main interest, on both sides, is to ensure the best for every part involved in labor process because this means, in the end, added value for everyone. The article focuses on the realities as well as on the expectations regarding the labor field highlighting the most preeminent aspects of the so called "E triangle": employment, employee and employer starting with the most needed definition for each and every one of the above going towards even to proposing remedies for the "spots" needing improvement.

The European Refugee Crisis from the Perspective of International Migration Governance

Directory of Open Access Journals (Sweden)

Xie Tingting

2015-11-01

Full Text Available The influx of refugees in Europe in 2015 has greatly increased, which not only affects the stability and unity of European society, but also exerts certain pressure on its economic development. In the face of the refugee crisis, it is a dilemma for the European countries to choose either humanitarian or national interests. Starting from the impact and challenge that international migration has had on effective governance within national boundaries, this paper uses the theories of international migration to analyze the three basic choices. Further, the authors provide a new way of thinking about the European refugee crisis from the perspective of international migration governance mechanisms. Of course, China should seize the opportunity to become an advocate of the international migration governance mechanism and rule maker of the global governance.

The European Refugee Crisis from the Perspective of International Migration Governance

Directory of Open Access Journals (Sweden)

Xie Tingting

2015-12-01

Full Text Available The influx of refugees in Europe in 2015 has greatly increased, which not only affects the stability and unity of European society, but also exerts certain pressure on its economic development. In the face of the refugee crisis, it is a dilemma for the European countries to choose either humanitarian or national interests. Starting from the impact and challenge that international migration has had on effective governance within national boundaries, this paper uses the theories of international migration to analyze the three basic choices. Further, the authors provide a new way of thinking about the European refugee crisis from the perspective of international migration governance mechanisms. Of course, China should seize the opportunity to become an advocate of the international migration governance mechanism and rule maker of the global governance.

Frequency and Predictors for Late Start of Antiretroviral Therapy in Primary Care Clinics, Kampala, Uganda

NARCIS (Netherlands)

Sendagire, Ibrahim; Cobelens, Frank; Kambugu, Andrew; Konde-Lule, Joseph; Schim van der Loeff, Maarten

2012-01-01

Background: Access to antiretroviral treatment (ART) has improved greatly in many parts of the world, including Uganda, yet, many patients delay to start ART even when registered within the HIV services. We assessed, in a routine ambulatory care setting, what proportion of patients start ART late

Real Driving Emissions in Congested Traffic: A Comparison of Cold and Hot Start

OpenAIRE

Khalfan, A; Andrews, GE; Li, H

2016-01-01

Air quality NO₂ and PM exceedances in cities are common, where congested traffic occurs and the monitoring station is at the roadside. This work investigated real world emissions for a Euro 4 SI vehicle on a congested road by a roadside air quality monitoring station that exceeds European air quality standards for NOx and PM. The PEMS used was the Temet FTIR with Horiba OBS pitot tube exhaust mass flow sensor and gas sampler. Twenty nine hot start repeat journeys were made at different times ...

Prediction of prevalence of chronic kidney disease in diabetic patients in countries of the European Union up to 2025.

Science.gov (United States)

Kainz, Alexander; Hronsky, Milan; Stel, Vianda S; Jager, Kitty J; Geroldinger, Angelika; Dunkler, Daniela; Heinze, Georg; Tripepi, Giovanni; Oberbauer, Rainer

2015-08-01

Diabetes and chronic kidney disease (CKD) are a growing burden for health-care systems. The prevalence of diabetes has increased constantly during the last decade, although a slight flattening of end-stage renal disease as a result of diabetes has been observed recently in some European countries. In this study, we project the prevalence of CKD in patients with diabetes in European countries up to the year 2025. We analysed the population with diabetes and development of nephropathy in 12 European countries, which we computed from models published previously and on data from the annual reports of the European Renal Association (1998-2011). The prevalence of CKD stage 5 in patients with diabetes up to the year 2025 was projected by the Lee-Carter algorithm. Those for stage 3 and 4 were then estimated by applying the same ratios of CKD prevalences as estimated in the Austrian population with diabetic nephropathy. The estimated prevalence of CKD in patients with diabetes is expected to increase in all 12 countries up to the year 2025. For CKD stage 3, we estimate for Austria in 2025 a prevalence of 215 000 per million diabetic population (p.m.p.) (95% confidence interval 169 000, 275 000), for CKD4 18 600 p.m.p. (14 500, 23 700) and for CKD5 6900 p.m.p. (5400, 8900). The median prevalence in the considered countries is 132 900 p.m.p. (IQR: 118 500, 195 800), 11 500 (10 200, 16 900) and 4300 (3800, 6300) for CKD stages 3, 4 and 5, respectively. Altogether, these data predict in the years 2012-25 an annual increase of 3.2% in the prevalence of diabetic CKD stage 5. Due to the increase in prevalence of diabetes and CKD5, the costs of renal therapy are expected to rise. We believe that these data may help health-care policy makers to make informed decisions. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

Directory of Open Access Journals (Sweden)

Belinchón I

2016-11-01

Full Text Available I Belinchón,1 R Rivera,2 C Blanch,3 M Comellas,4 L Lizán4,5 1Department of Dermatology, Hospital General Universitario de Alicante, Alicante, 2Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, 3Novartis Farmacéutica S.A., Barcelona, 4Outcomes’10, Castellón, Spain; 5Medical Department, University Jaime I, Castellón, Spain Background and objective: Adherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU.Methods: Electronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts’ opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded.Results: A total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4, preferences (n=5 and satisfaction with treatment (n=7. Results related to health-related quality of life articles (n=30 have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is

European Surveillance System on Contact Allergies (ESSCA)

DEFF Research Database (Denmark)

Uter, W; Amario-Hita, J C; Balato, A

2017-01-01

BACKGROUND: Contact allergy is a common condition and can severely interfere with daily life or professional activities. Due to changes in exposures, such as introduction of new substances, new products or formulations and regulatory intervention, the spectrum of contact sensitization changes....... OBJECTIVE: To evaluate the current spectrum of contact allergy to allergens present in the European baseline series (EBS) across Europe. METHODS: Retrospective analysis of data collected by the European Surveillance System on Contact Allergies (ESSCA, www.essca-dc.org) in consecutively patch-tested patients......, 2013/14, in 46 departments in 12 European countries. RESULTS: Altogether, 31 689 patients were included in the analysis. Compared to a similar analysis in 2004, the prevalence of contact allergy to methylisothiazolinone went up to around 20% in several departments. In comparison, contact allergy...

Validity of the European society of cardiology's psychosocial screening interview in patients with coronary artery disease : The THORESCI study

NARCIS (Netherlands)

van Montfort, E.M.J.; Denollet, J.; Widdershoven, J.W.M.G.; Kupper, N.

2017-01-01

Objective: The aim of the study was to examine the validity of the European Society of Cardiology (ESC) psychosocial screening instrument. Methods: A total of 508 acute (67%) or elective (33%) percutaneous coronary intervention patients (mean [standard deviation]age = 63 [10] years, 81% male)

The European Trauma Course (ETC) and the team approach

DEFF Research Database (Denmark)

Lott, Carsten; Araujo, Rui; Cassar, Mary Rose

2009-01-01

The European Trauma Course (ETC) was officially launched during the international conference of the European Resuscitation Council (ERC) in 2008. The ETC was developed on behalf of ESTES (European Society of Trauma and Emergency Surgery), EuSEM (European Society of Emergency Medicine), the ESA...... (European Society of Anaesthesiology) and the ERC. The objective of the ETC is to provide an internationally recognised and certified life support course, and to teach healthcare professionals the key principles of the initial care of severely injured patients. Its core elements, that differentiates it from...

Major knowledge gaps and system barriers to guideline implementation among European physicians treating patients with atrial fibrillation: a European Society of Cardiology international educational needs assessment.

Science.gov (United States)

Heidbuchel, Hein; Dagres, Nikolaos; Antz, Matthias; Kuck, Karl-Heinz; Lazure, Patrice; Murray, Suzanne; Carrera, Céline; Hindricks, Gerhard; Vahanian, Alec

2018-03-12

Guideline-adherent treatment is associated with improved prognosis in atrial fibrillation (AF) patients but is insufficiently implemented in clinical practice. The European Society of Cardiology (ESC) performed a multinational educational needs assessment study among cardiologists, general practitioners/family physicians (GPs/FPs), and neurologists in order to evaluate knowledge and skills of physicians and system factors related to AF care delivery. A total of 561 physicians (294 cardiologists, 131 neurologists, and 136 GPs/FPs) from six European countries participated. This mixed-methods study included exploratory semi-structured qualitative interviews (n = 30) and a quantitative survey that included two clinical cases (n = 531). We identified eight key knowledge gaps and system barriers across all domains of AF care. A majority across all specialties reported skills needing improvement to classify AF pathophysiologically, rather than based on duration of episodes, and reported lack of availability of long-term electrocardiogram recording. Skills interpreting the CHA2DS2-VASc and the HAS-BLED scores were reported as needing improvement by the majority of neurologists (52% and 60%, respectively) and GPs/FPs (65% and 74%). Cardiologists calculated the CHA2DS2-VASc and HAS-BLED scores in 94%/70% in a presented case patient, but only 60%/49% of neurologists and 58%/42% of GPs/FPs did. There was much uncertainty on how to deal with anticoagulant therapy in complex patients. There was also a high disparity in using rate or rhythm control strategies, and indications for ablation. Information delivery to patients and communication between different specialties was often considered suboptimal, while national regulations and restrictions often hamper international guideline implementation. We identified major gaps in physicians' knowledge and skills across all domains of AF care, as well as system factors hampering guideline-compliant care implementation and

Trends in the internationalization of European higher education in a convergence perspective

Directory of Open Access Journals (Sweden)

Dima Alina Mihaela

2016-07-01

Full Text Available The paper proposes several indicators for the degree of convergence in the internationalization of European higher education, based on previous research on the topic and on the availability of data in the large repositories, such as Eurostat. Starting from longitudinal data series built using the values of the selected indicators in 2015; we have grouped European higher education systems in clusters, based on their similarity, that is, potential for medium term convergence. These findings may serve as a guiding methodology for further, more detailed investigations on convergence and divergence of higher education systems in Europe. The main limitations arise from the availability of data, more specifically from the lack of in-depth data collection at the European level.

Eccentric LVH healing after starting renal replacement therapy.

Science.gov (United States)

Vertolli, Ugo; Lupia, Mario; Naso, Agostino

2002-01-01

Hypertension and left ventricular hypertrophy (LVH) are commonly associated in patients with CRF starting RDT. We report a case of eccentric LVH with marked dilatation and subsequent mitral incompetence of +3/4 that disappeared after three months of standard hemodialysis. Mrs SN, 62 years old, starting HD, had an echocardiography because of dyspnoea; the echo showed: dilated left atrium (78 ml/m2), moderately dilated left ventricle with normal systolic function (TDV 81 ml/m2, EF 66%), an increased ventricular mass (120 gr/m2) and a high grade mitral incompetence +3/4. After three months standard RDT and a dry weight only 2 kg less, the patients was normotensive without therapy, a cardiac angiogram with a hemodynamic study was performed as a pre-transplant workout: a normal left ventricle was found with normal systolic function (TDV 66, TSV 17, GS 49, EF 75%), and a perfectly competent mitral valve (reflux disappeared). The coronary angiography did not reveal critical stenosis. A new echocardiography confinned the data of the hemodynamic study: hypertensive cardiomiopathy with normal systolic function. After one year the patient has been transplanted, with a good renal function and the cardiac echo unchanged. Relieving uremic toxicity ameliorated the cardiac performance in this particular patient.

Application of STOPP and START criteria: interrater reliability among pharmacists.

LENUS (Irish Health Repository)

Ryan, Cristin

2009-07-01

Inappropriate prescribing is a well-documented problem in older people. The new screening tools, STOPP (Screening Tool of Older Peoples\\' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) have been formulated to identify potentially inappropriate medications (PIMs) and potential errors of omissions (PEOs) in older patients. Consistent, reliable application of STOPP and START is essential for the screening tools to be used effectively by pharmacists.

Administrative Reform in Romania and the European Union

OpenAIRE

Călin HINŢEA; Sorin Dan ŞANDOR; Veronica JUNJAN

2002-01-01

The issue of public administration reform is an old one for the professional literature. It has always been at the basis of a significant theoretical debate that started with the idea of compatibility between the concepts of “public administration” and “reform”. Central and Eastern European countries have been faced with the acute need of reform after the crash of communist regimes and painful disclosure of the inefficiency of previous bureaucratic models.

OFICIUL EUROPEAN DE POLIŢIE - EUROPOL

Directory of Open Access Journals (Sweden)

Angelica Chirila

2008-05-01

Full Text Available Europol is the European Law Enforcement Organisation which aims at improving theeffectiveness and co-operation of the competent authorities in the Member States in preventing and combatingterrorism, unlawful drug trafficking and other serious forms of international organised crime.The establishment of Europol was agreed in the Maastricht Treaty on European Union of 7 February1992. Based in The Hague, Netherlands, Europol started limited operations on 3 January 1994 in the form of theEuropol Drugs Unit (EDU fighting against drugs. Progressively, other important areas of criminality wereadded. On 1 January 2002, the mandate of Europol was extended to deal with all serious forms of internationalcrime as listed in the annex to the Europol Convention. The Europol Convention was ratified by all MemberStates and came into force on 1 October 1998. Following a number of legal acts related to the Convention,Europol commenced its full activities on 1 July 1999.

Lean start-up

DEFF Research Database (Denmark)

Rasmussen, Erik Stavnsager; Tanev, Stoyan

2016-01-01

The risk of launching new products and starting new firms is known to be extremely high. The Lean Start-up approach is a way of reducing these risks and enhancing the chances for success by validating the products and services in the market with customers before launching it in full scale. The ma...... and the final business model. In other words: The start-up must first nail the problem together with the customers, then develop the solution and test, and then in the end scale it to a full-grown business model.......The risk of launching new products and starting new firms is known to be extremely high. The Lean Start-up approach is a way of reducing these risks and enhancing the chances for success by validating the products and services in the market with customers before launching it in full scale. The main...

Public services in early modern European towns: An agenda for further research

NARCIS (Netherlands)

Davids, C.A.

2010-01-01

Starting with a set of key questions formulated by Walter Prevenier in 1984, this article proposes an agenda for future research on urban public services in early modern European towns. The author suggests, first of all, a shift in research strategy toward a greater emphasis on actor-oriented

Decrease in sick leave among patients with rheumatoid arthritis in the first 12 months after start of treatment with tumour necrosis factor antagonists: a population-based controlled cohort study.

Science.gov (United States)

Olofsson, Tor; Englund, Martin; Saxne, Tore; Jöud, Anna; Jacobsson, Lennart T H; Geborek, Pierre; Allaire, Saralynn; Petersson, Ingemar F

2010-12-01

To investigate the effect of tumour necrosis factor (TNF) antagonist treatment of patients with rheumatoid arthritis (RA) on sick leave (SL) and disability pension (DP) in a population-based setting in southern Sweden. All patients with RA in the South Swedish Arthritis Treatment Group register living in the county of Skåne (population 1.2 million), who started their first treatment with a TNF antagonist between January 2004 and December 2007 and were 18-58 years at treatment start (n = 365), were identified. For each patient with RA, four matched reference subjects from the general population were randomly selected. Data were linked to the Swedish Social Insurance Agency register and the point prevalence of SL and DP as well as days of SL and DP per month were calculated from 360 days before until 360 days after treatment start. At treatment start 38.6% of the patients with RA were registered for SL. During the first 6 months this share dropped to 28.5% (decrease by 26.2%, ptreatment year. Comparing patients with RA to the reference group the relative risk of being on SL was 6.6 (95% CI 5.2 to 8.5) at initiation of anti-TNF treatment and 5.2 (95% CI 4.0 to 6.8) 1 year after that. The corresponding figures for DP were 3.4 (95% CI 2.7 to 4.2) and 3.2 (95% CI 2.7 to 3.9). There was a marked decline in SL during the first 6 months of TNF antagonist treatment in patients with RA in southern Sweden, maintained throughout the first year, which was not offset by a corresponding increase in DP.

Status of the European Atlas of Natural Radiation

International Nuclear Information System (INIS)

Bossew, P.; Tollefsen, T.; Cinelli, G.; De Cort, M.; Gruber, V.

2015-01-01

According to the EURATOM (European Atomic Energy Community) Treaty, one of the missions of the Joint Research Centre (JRC) of the European Commission (EC) is to collect, process, evaluate and present data on environmental radioactivity. In 2006, the JRC started the 'European Atlas of Natural Radiation' project, in order to give an overview of the geographic distribution of sources of, and exposures to, natural radiation. As a first task, a map of indoor radon concentration was created, because in most cases this is the most important contribution to exposure, and since it could be expected that data collection would take quite some time, because radon (Rn) surveys are very differently advanced between European countries. The authors show the latest status of this map. A technically more ambitious map proved the one of the geo-genic Rn potential (RP), due to heterogeneity of data sources across Europe and the need to develop models to estimate a harmonised quantity which adequately measures or classifies the RP. Further maps currently in the making include those of secondary cosmic radiation, of terrestrial gamma radiation and of the concentrations of the elements U, Th and K that are its source. In this article, the authors show the progress of some of these maps. (authors)

The Safety and Immunogenicity of Live Zoster Vaccination in Patients With Rheumatoid Arthritis Before Starting Tofacitinib: A Randomized Phase II Trial.

Science.gov (United States)

Winthrop, Kevin L; Wouters, Ann G; Choy, Ernest H; Soma, Koshika; Hodge, Jennifer A; Nduaka, Chudy I; Biswas, Pinaki; Needle, Elie; Passador, Sherry; Mojcik, Christopher F; Rigby, William F

2017-10-01

Patients with rheumatoid arthritis (RA) are at increased risk of herpes zoster, and vaccination is recommended for patients ages 50 years and older, prior to starting treatment with biologic agents or tofacitinib. Tofacitinib is an oral JAK inhibitor for the treatment of RA. We evaluated its effect on the immune response and safety of live zoster vaccine (LZV). In this phase II, 14-week, placebo-controlled trial, patients ages 50 years and older who had active RA and were receiving background methotrexate were given LZV and randomized to receive tofacitinib 5 mg twice daily or placebo 2-3 weeks postvaccination. We measured humoral responses (varicella zoster virus [VZV]-specific IgG level as determined by glycoprotein enzyme-linked immunosorbent assay) and cell-mediated responses (VZV-specific T cell enumeration, as determined by enzyme-linked immunospot assay) at baseline and 2 weeks, 6 weeks, and 14 weeks postvaccination. End points included the geometric mean fold rise (GMFR) in VZV-specific IgG levels (primary end point) and T cells (number of spot-forming cells/10 6 peripheral blood mononuclear cells) at 6 weeks postvaccination. One hundred twelve patients were randomized to receive tofacitinib (n = 55) or placebo (n = 57). Six weeks postvaccination, the GMFR in VZV-specific IgG levels was 2.11 in the tofacitinib group and 1.74 in the placebo group, and the VZV-specific T cell GMFR was similar in the tofacitinib group and the placebo group (1.50 and 1.29, respectively). Serious adverse events occurred in 3 patients in the tofacitinib group (5.5%) and 0 patients (0.0%) in the placebo group. One patient, who lacked preexisting VZV immunity, developed cutaneous vaccine dissemination 2 days after starting tofacitinib (16 days postvaccination). This resolved after tofacitinib was discontinued and the patient received antiviral treatment. Patients who began treatment with tofacitinib 2-3 weeks after receiving LZV had VZV-specific humoral and cell

Low-cost airlines in Europe: Network structures after the enlargement of the European Union

Directory of Open Access Journals (Sweden)

Dudas Gabor

2010-01-01

Full Text Available The liberalization of the European air opened the strictly regulated European market, and contributed to the appearance and quick spread of the Low-Cost Carriers (LCCs. At the beginning of the 21st century the low cost traffic absolutely concentrated on the Western European market but after the enlargement of the European Union (EU LCCs started their operations in Eastern Europe enlarging and enriching the former evolved network structures. The aim of this paper is to trace the evolution of the route network as a result of EU expansion. During the study we came to the conclusion that in the time period after the EU enlargement the European LCC traffic showed dynamic development, route networks widened and the number of accessible destinations doubled. Comparing the LCCs network structures we defined three main characteristics, which represents the North-South flows, the West-East routes and the mixed network structure.

Key parameters of the swimming start and their relationship to start performance.

Science.gov (United States)

Tor, Elaine; Pease, David L; Ball, Kevin A

2015-01-01

The swimming start is typically broken into three sub-phases; on-block, flight, and underwater phases. While overall start performance is highly important to elite swimming, the contribution of each phase and important technical components within each phase, particularly with the new kick-start technique, has not been established. The aim of this study was to identify technical factors associated with overall start performance, with a particular focus on the underwater phase. A number of parameters were calculated from 52 starts performed by elite freestyle and butterfly swimmers. These parameters were split into above-water and underwater groupings, before factor analysis was used to reduce parameter numbers for multiple regression. For the above-water phases, 81% of variance in start performance was accounted for by take-off horizontal velocity. For the underwater water phase, 96% of variance was accounted for with time underwater in descent, time underwater in ascent and time to 10 m. Therefore, developing greater take-off horizontal velocity and focussing on the underwater phase by finding the ideal trajectory will lead to improved start performance.

European tendencies and co-operation in the field of ITS systems - national achievements and challenges in Hungary

Directory of Open Access Journals (Sweden)

Lindenbach Ágnes

2016-06-01

Full Text Available The article presents the role of intelligent transport systems/services related to the implementation of the essential European and Hungarian transport policy objectives. The ‘ITS Directive’ will provide a framework for the tasks/works to be performed in the forthcoming years within the priority areas of ITS. The European Commission published regulations / specifications for the priority actions in the form of delegated acts defining the tasks/responsibilities of Member States. Regional/European co-operation for Hungary started after the EU-accession of the country. Hungary was an active partner within the European CONNECT and EasyWay projects, currently Hungary is a member of the CROCODILE consortium.

From START to NEW START. The dilemma and future of nuclear disarmament; Von START zu NEW START. Das Dilemma und die Zukunft der Nuklearen Abruestung

Energy Technology Data Exchange (ETDEWEB)

Plettenberg, Lars

2012-07-01

The report describes the existing four agreements on nuclear disarmament: START I (1991). START II (1993), SORT (2002) and NEW START (2010). The chapter on the dependence between nuclear disarmament and strategic stability covers the issues mutual assured destruction (MAD), credibility, overkill capacity; the role of nuclear weapons in the national strategies of the USA and NATO, Russia, Great Britain, France, China and the other nuclear states. Ways out of MAD include disarmament, de-alerting and mutual assured protection (MAP).

A European multi-language initiative to make the general population aware of independent clinical research: the European Communication on Research Awareness Need project

OpenAIRE

Mosconi, Paola; Antes, Gerd; Barbareschi, Giorgio; Burls, Amanda; Demotes-Mainard, Jacques; Chalmers, Iain; Colombo, Cinzia; Garattini, Silvio; Gluud, Christian; Gyte, Gill; Mcllwain, Catherine; Penfold, Matt; Post, Nils; Satolli, Roberto; Valetto, Maria Rosa

2016-01-01

BACKGROUND: The ECRAN (European Communication on Research Awareness Needs) project was initiated in 2012, with support from the European Commission, to improve public knowledge about the importance of independent, multinational, clinical trials in Europe. \\ud \\ud METHODS: Participants in the ECRAN consortium included clinicians and methodologists directly involved in clinical trials; researchers working in partnership with the public and patients; representatives of patients; and experts in s...

The European Nucelar Engineering Network Program (ENEN)

International Nuclear Information System (INIS)

Villa, M.; Boeck, H.; Hajek, M.

2002-01-01

As of 2002 there are 439 Nuclear Power Plants (NPP) and 264 Research Reactors (RR) in operation world-wide, out of these countries, 11 countries in Europe account for 145 NPP and 18 countries in Europe for 37 RR. A large fraction of both the NPP and the RR are over 30 years old. The same age problem exists also among the qualified nuclear staff. Most of the nuclear staff joined those facilities in the 60-ties and 70-ties and are now approaching retirement age. Due to this fact a large amount of experience and competence will be lost in the next decade [1]. Therefore it is of utmost importance to improve and harmonize the nuclear educational system among European countries. Having this target in mind an EU project, the European Nuclear Engineering Network (ENEN), was submitted by 17 countries to the European Union. The proposal was accepted and the two year project started officially on January 1's't 2002. In this paper a survey on the history and the structure of ENEN is given, the targets and timetables of the individual 10 Work Packages are discussed and the results up to September 2002 are presented.(author)

The European Nucelar Engineering Network Program (ENEN)

Energy Technology Data Exchange (ETDEWEB)

Villa, M; Boeck, H; Hajek, M [Atominstitut der Oesterreichischen Universitaeten, Vienna (Austria)

2002-07-01

As of 2002 there are 439 Nuclear Power Plants (NPP) and 264 Research Reactors (RR) in operation world-wide, out of these countries, 11 countries in Europe account for 145 NPP and 18 countries in Europe for 37 RR. A large fraction of both the NPP and the RR are over 30 years old. The same age problem exists also among the qualified nuclear staff. Most of the nuclear staff joined those facilities in the 60-ties and 70-ties and are now approaching retirement age. Due to this fact a large amount of experience and competence will be lost in the next decade [1]. Therefore it is of utmost importance to improve and harmonize the nuclear educational system among European countries. Having this target in mind an EU project, the European Nuclear Engineering Network (ENEN), was submitted by 17 countries to the European Union. The proposal was accepted and the two year project started officially on January 1's't 2002. In this paper a survey on the history and the structure of ENEN is given, the targets and timetables of the individual 10 Work Packages are discussed and the results up to September 2002 are presented.(author)

[European Union and blood transfusion].

Science.gov (United States)

Rouger, P

2003-06-01

Blood transfusion is progressing, Europe is growing, European blood transfusion organisations are developing rapidly. The first step was the publication of a new directive (2002/98/CE). The directive is the result of a compromise between technocracy, lobbying and blood transfusion professionals. European blood transfusion must be based on medical, scientific and social criteria. Two imperatives must be considered: the respect of ethics and; independence from the commercial system. The primary objective is to give satisfaction to patients while respecting blood donors.

Policy options for the improvement of the European patent system

DEFF Research Database (Denmark)

Elsmore, Matthew J.

2008-01-01

This project has been initiated - and this report written - in order to assess how the European patent system best fulfils its objective of defining the exclusive rights granted to inventors so as to further the goal of enhancing social and economic welfare by means of encouraging inventions...... and their distribution. Finding the right balance is important, since the reward offered to inventors in the form of exclusive rights provides the incentive to innovate, but if the reward is too excessive, it may hamper innovation and the distribution of knowledge. The general premise of this report is that the European...... patent system has so far been a positive factor in promoting innovation. Therefore, it is not the objective of the report to evaluate whether such system should or should not exist. Rather, the report works from the starting position that the European patent system may be operating in certain ways...

Screening for Corynebacterium diphtheriae and Corynebacterium ulcerans in patients with upper respiratory tract infections 2007-2008: a multicentre European study.

LENUS (Irish Health Repository)

Wagner, K S

2011-04-01

Diphtheria is now rare in most European countries but, when cases do arise, the case fatality rate is high (5-10%). Because few countries continue to routinely screen for the causative organisms of diphtheria, the extent to which they are circulating amongst different European populations is largely unknown. During 2007-2008, ten European countries each screened between 968 and 8551 throat swabs from patients with upper respiratory tract infections. Six toxigenic strains of Corynebacterium diphtheriae were identified: two from symptomatic patients in Latvia (the country with the highest reported incidence of diphtheria in the European Union) and four from Lithuania (two cases, two carriers); the last reported case of diphtheria in Lithuania was in 2002. Carriage rates of non-toxigenic organisms ranged from 0 (Bulgaria, Finland, Greece, Ireland, Italy) to 4.0 per 1000 (95% CI 2.0-7.1) in Turkey. A total of 28 non-toxigenic strains were identified during the study (26 C. diphtheriae, one Corynebacterium ulcerans, one Corynebacterium pseudotuberculosis). The non-toxigenic C. ulcerans strain was isolated from the UK, the country with the highest reported incidence of cases due to C. ulcerans. Of the eleven ribotypes detected, Cluj was seen most frequently in the non-toxigenic isolates and, amongst toxigenic isolates, the major epidemic clone, Sankt-Petersburg, is still in circulation. Isolation of toxigenic C. diphtheriae and non-toxigenic C. diphtheriae and C. ulcerans in highly-vaccinated populations highlights the need to maintain microbiological surveillance, laboratory expertise and an awareness of these organisms amongst public health specialists, microbiologists and clinicians.

Infraorbital nerve involvement on magnetic resonance imaging in European patients with IgG4-related ophthalmic disease: a specific sign

Energy Technology Data Exchange (ETDEWEB)

Soussan, J. Ben; Sadik, J.C.; Savatovsky, J.; Heran, F.; Lecler, A. [Fondation Ophtalmologique Adolphe de Rothschild, Department of Radiology, Paris (France); Deschamps, R. [Fondation Ophtalmologique Adolphe de Rothschild, Department of Neurology, Paris (France); Deschamps, L. [Bichat Hospital, APHP, Department of Pathology, Paris (France); Puttermann, M. [Necker-Enfants Malades Hospital, APHP, Department of Pathology, Paris (France); Zmuda, M.; Galatoire, O. [Fondation Ophtalmologique Adolphe de Rothschild, Department of Orbitopalpebral Surgery, Paris (France); Picard, H. [Fondation Ophtalmologique Adolphe de Rothschild, Clinical Research Unit, Paris (France)

2017-04-15

To measure the frequency of infraorbital nerve enlargement (IONE) on magnetic resonance imaging (MRI) in European patients suffering from an IgG4-related ophthalmic disease (IgG4-ROD) as compared to patients suffering from non-IgG4-related ophthalmic disease (non-IgG4-ROD). From January 2006 through April 2015, 132 patients were admitted for non-lymphoma, non-thyroid-related orbital inflammation. Thirty-eight had both pre-therapeutic orbital MRI and histopathological IgG4 immunostaining. Fifteen patients were classified as cases of IgG4-ROD and 23 patients as cases of non-IgG4-ROD. Two readers performed blinded analyses of MRI images. The main criterion was the presence of an IONE, defined as the infraorbital nerve diameter being greater than the optic nerve diameter in the coronal section. IONE was present in 53% (8/15) of IgG4-ROD cases whereas it was never present (0/23) in cases of non-IgG4-ROD (P < 0.0001). IONE was only present in cases where, on MRI, the inflammation of the inferior quadrant was present and in direct contact with the ION canal. In European patients suffering from orbital inflammation, the presence of IONE on an MRI is a specific sign of IgG4-ROD. Recognition of this pattern may facilitate the accurate diagnosis for clinicians and allow for the adequate management and appropriate care of their patients. (orig.)

Infraorbital nerve involvement on magnetic resonance imaging in European patients with IgG4-related ophthalmic disease: a specific sign

International Nuclear Information System (INIS)

Soussan, J. Ben; Sadik, J.C.; Savatovsky, J.; Heran, F.; Lecler, A.; Deschamps, R.; Deschamps, L.; Puttermann, M.; Zmuda, M.; Galatoire, O.; Picard, H.

2017-01-01

To measure the frequency of infraorbital nerve enlargement (IONE) on magnetic resonance imaging (MRI) in European patients suffering from an IgG4-related ophthalmic disease (IgG4-ROD) as compared to patients suffering from non-IgG4-related ophthalmic disease (non-IgG4-ROD). From January 2006 through April 2015, 132 patients were admitted for non-lymphoma, non-thyroid-related orbital inflammation. Thirty-eight had both pre-therapeutic orbital MRI and histopathological IgG4 immunostaining. Fifteen patients were classified as cases of IgG4-ROD and 23 patients as cases of non-IgG4-ROD. Two readers performed blinded analyses of MRI images. The main criterion was the presence of an IONE, defined as the infraorbital nerve diameter being greater than the optic nerve diameter in the coronal section. IONE was present in 53% (8/15) of IgG4-ROD cases whereas it was never present (0/23) in cases of non-IgG4-ROD (P < 0.0001). IONE was only present in cases where, on MRI, the inflammation of the inferior quadrant was present and in direct contact with the ION canal. In European patients suffering from orbital inflammation, the presence of IONE on an MRI is a specific sign of IgG4-ROD. Recognition of this pattern may facilitate the accurate diagnosis for clinicians and allow for the adequate management and appropriate care of their patients. (orig.)

Comparing Chinese and European American mental health decision making.

Science.gov (United States)

Gao, Shanshan; Corrigan, Patrick W; Qin, Sang; Nieweglowski, Katherine

2017-12-20

Shared decision making (SDM) tends to reflect more Western values of individualism and empowerment, values that may be foreign to East Asian healthcare preferences for collectivism and family involvement: family centered decision making (FCDM). To show that Chinese will be more likely to believe FCDM would be more pleasing for them if they were the patient. Conversely, European Americans will respond more favorably to SDM. To examine effects of Western acculturation on FCDM compared to SDM. In this study, preferences for FCDM versus SDM and doctor-led decision making (DrDM) were examined in a vignette study completed online by European Americans (n = 298) and Chinese (n = 327). Research participants read a vignette about Lily (a depression patient) presenting with symptoms of depression. After reading the vignette, participants completed items representing two sets of outcomes: three perceptions of impact on Lily and how participants might respond for themselves in a similar decision making situation. Chinese rated FCDM greater than European and Chinese Americans. Chinese Americans mostly responded similar to European Americans and not Chinese. European Americans prefer SDM more for mental health services. Chinese value FCDM more than European Americans. Preferences of Chinese living in America seem to parallel European Americans.

EURO UNDER CROSSFIRE. WILL THE EUROPEAN MONETARY UNION SURVIVE?

Directory of Open Access Journals (Sweden)

Roxana Paraschiv

2011-12-01

Full Text Available The creation of the European Monetary Union was both a political and an economic decision considered to be a success for almost a decade. Starting from 2008-2009, the EMU has been facing the most difficult moments of its existence. This paper aims at analyzing the impact of the current financial crises on the EMU member countries, the measures taken up to the present as a response to the crises and the future perspective for the European single currency. Both the breaking up of the EMU and its maintaining prove to be costly decisions. The recent evolutions have shown the political will to keep the EMU together, but we must ask ourselves at what price and risk.

The management of evaluating the European programs and policies implemented in Romania

Directory of Open Access Journals (Sweden)

Doctoral student ROMAN MIHAELA

2011-12-01

Full Text Available Starting with the reform and modernization of the public administration in Romania in the mid 1990s, an important element of this process being the development of the management process, respectively of planning and managing public policies, the Romanian government started also a process of developing the capacity for evaluating public programs and policies, both the ones with European or foreign financing and the ones with domestic financing. Up-to-date analyses and studies have showed, however, that at the level of the national public sector there is a major discrepancy between the progress made in the evaluation of European programs or the ones with foreign financing and the programs financed from public funds, namely that there is a consolidated evaluation practice as regards the first types of programs, which is virtually inexistent as regards programs financed from the public budget.This paper intends to identify the progress made at the level of the Romanian public administration as regards the management of evaluating programs with European financing, to see the characteristics of building the evaluation capacity within the national system of these programs and the motivation stimulating such approaches. The first part of this paper shall contain a presentation of the background of the current evaluation system, including both the legislative framework and the institutional framework with duties of management and evaluation of European programs; further, I shall analyze the evolution of this system in order to be able to draw conclusions regarding the evaluation capacity of Romania.

European and Czech principles of contract law

OpenAIRE

Horáková, Monika

2008-01-01

8 Summary European and Czech Principles of Contract Law This thesis is focused on principles of contract law. In the first instance, it explains the theoretical conception of principles of law and adverts to their status in the Czech legal system. The second Chapter of the thesis dissertates about basic principles of the Czech private law starting with the principle of freedom of contract, ends with the principles of good faith and fair dealing. The main part of the thesis deals with the Euro...

European supercritical water cooled reactor

International Nuclear Information System (INIS)

Schulenberg, T.; Starflinger, J.; Marsault, P.; Bittermann, D.; Maraczy, C.; Laurien, E.; Lycklama a Nijeholt, J.A.; Anglart, H.; Andreani, M.; Ruzickova, M.; Toivonen, A.

2011-01-01

Highlights: → The HPLWR reactor design is an example of a supercritical water cooled reactor. → Cladding material tests have started but materials are not yet satisfactory. → Numerical heat transfer predictions are promising but need further validation. → The research project is most suited for nuclear education and training. - Abstract: The High Performance Light Water Reactor (HPLWR), how the European Supercritical Water Cooled Reactor is called, is a pressure vessel type reactor operated with supercritical water at 25 MPa feedwater pressure and 500 o C average core outlet temperature. It is designed and analyzed by a European consortium of 10 partners and 3 active supporters from 8 Euratom member states in the second phase of the HPLWR project. Most emphasis has been laid on a core with a thermal neutron spectrum, consisting of small fuel assemblies in boxes with 40 fuel pins each and a central water box to improve the neutron moderation despite the low coolant density. Peak cladding temperatures of the fuel rods have been minimized by heating up the coolant in three steps with intermediate coolant mixing. The containment design with its safety and residual heat removal systems is based on the latest boiling water reactor concept, but with different passive high pressure coolant injection systems to cause a forced convection through the core. The design concept of the steam cycle is indicating the envisaged efficiency increase to around 44%. Moreover, it provides the constraints to design the components of the balance of the plant. The project is accompanied by numerical studies of heat transfer of supercritical water in fuel assemblies and by material tests of candidate cladding alloys, performed by the consortium and supported by additional tests of the Joint Research Centre of the European Commission. Besides the scientific and technical progress, the HPLWR project turned out to be most successful in training the young generation of nuclear engineers

Start of new Research and Innovation Programme, Horizon 2020

CERN Multimedia

2013-01-01

The overall EU budget for 2014-2020 was approved on 20 November, with €79 billion allocated for the Horizon 2020 Research and Innovation programme.   The first calls and final work programmes in Horizon 2020 will be published on 11 December 2013 and the programme will officially start on 1 January 2014. In preparation for the next major programme, the CERN EU Projects Office has launched a redesigned website to keep you informed and to alert you to opportunities in Horizon 2020: cerneu.web.cern.ch. Organised by Euresearch, the Swiss launch event will take place from 14 to 17 January 2014. This four-day conference will offer the possibility to discover the new European Framework Programme for Research and Innovation. The event is open for registration: www.launch-h2020.ch.

Creating a business toolbox for a start-up : a case study of SnapSwap International

OpenAIRE

Kovshikov, Iaroslav

2017-01-01

This thesis was implemented at SnapSwap International in spring and summer 2017. The case company is a fin-tech start-up established in 2015 and located in Luxembourg. The company aims to develop a new payment solution (money messenger) for the European market. The purpose of the thesis is to observe commonly used business techniques (SWOT, Business Model Canvas (BMC), Persona, and Empathy Map) and analyze current business activities of the company employing these tools. The theoretic...

Cardiac troponin T predicts occult coronary artery stenosis in patients with chronic kidney disease at the start of renal replacement therapy.

Science.gov (United States)

Hayashi, Terumasa; Obi, Yoshitsugu; Kimura, Tomonori; Iio, Ken-Ichiro; Sumitsuji, Satoru; Takeda, Yoshihiro; Nagai, Yoshiyuki; Imai, Enyu

2008-09-01

The high prevalence of asymptomatic coronary artery stenosis (CAS) in chronic kidney disease (CKD) has emerged as an important predictor of outcome. However, diagnostic tools that can identify asymptomatic CAS have not yet been established. We investigated whether asymptomatic patients at the initiation of renal replacement therapy (RRT) could be screened using cardiac troponin T (cTnT) and atherosclerotic surrogate markers such as ankle-brachial blood pressure index (ABPI) and intima-media thickness (IMT). Among 142 patients who were about to start RRT, 60 who were asymptomatic underwent coronary evaluation by multi-slice computed tomography (MSCT) and/or coronary angiography (CAG). CAG diagnosed 35 patients (43.8%) as CAS positive and 27 of them had multi-vessel disease. Factors associated with CAS were smoking, elevated cTnT, low ABPI and high IMT. Moreover, the severity of CAS was associated with smoking, cTnT and ABPI. Stepwise logistic regression analyses revealed that cTnT was a powerful predictor of asymptomatic multi-vessel CAS. Receiver operating characteristic analysis documented the usefulness of cTnT as a screening tool with a cut-off point 0.05 ng/ml. The optimal screening tool for multi-vessel CAS was cTnT (sensitivity, 92.6%; 95% CI, 82.7-99.9; specificity, 63.6%; 95% CI, 47.2-80.0). We concluded that cTnT should be measured as part of a strategy for detecting asymptomatic CAS, especially multi-vessel disease in patients with CKD at the start of RRT.

Overview of decommissioning research and development activities in the European Community

International Nuclear Information System (INIS)

Huber, B.

1982-01-01

The European Community's research program on the decommissioning of nuclear power plants is managed by the Commission of the European Communities and carried out by national laboratories and private firms under cost-sharing contracts. Starting in 1980, about fifty research contracts covering a large variety of topics have been let so far. The paper outlines the content, progress and selected results of the seven projects composing the program. These projects concern the following subjects: maintaining disused plants in a safe condition; decontamination for decommissioning purposes; dismantling techniques; treatment of waste materials; large waste containers; estimation of waste arisings; and plant design features facilitating decommissioning. 4 references

Recommendations for successful substantiation of new health claims in the European Union

DEFF Research Database (Denmark)

Pravst, Igor; Kušar, Anita; Žmitek, Katja

2018-01-01

Background While functional foods offer promise for public health and innovation in the food industry, the efficiency of such foods should be assured to protect consumers from misleading claims. Globally, many countries regulate the communication of the health effects of such foods to final...... consumers. Scope and approach In the European Union (EU), the use of health claims was harmonized in 2006. All claims need to be scientifically assessed by the European Food Safety Authority (EFSA) and pre-approved. Implementing the regulation has involved a steep learning curve for stakeholders, resulting...... recommendations should be seen as a starting point for researchers in the area of nutrition and food technology, and for those dealing with functional foods, including the food industry. Keywords Functional foods; Health claims; Food labelling; Substantiation; Regulation; European Union...

Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria.

LENUS (Irish Health Repository)

Gallagher, P F

2011-06-01

Inappropriate prescribing is particularly common in older patients and is associated with adverse drug events (ADEs), hospitalization, and wasteful utilization of resources. We randomized 400 hospitalized patients aged ≥ 65 years to receive either the usual pharmaceutical care (control) or screening with STOPP\\/START criteria followed up with recommendations to their attending physicians (intervention). The Medication Appropriateness Index (MAI) and Assessment of Underutilization (AOU) index were used to assess prescribing appropriateness, both at the time of discharge and for 6 months after discharge. Unnecessary polypharmacy, the use of drugs at incorrect doses, and potential drug-drug and drug-disease interactions were significantly lower in the intervention group at discharge (absolute risk reduction 35.7%, number needed to screen to yield improvement in MAI = 2.8 (95% confidence interval 2.2-3.8)). Underutilization of clinically indicated medications was also reduced (absolute risk reduction 21.2%, number needed to screen to yield reduction in AOU = 4.7 (95% confidence interval 3.4-7.5)). Significant improvements in prescribing appropriateness were sustained for 6 months after discharge.

Multi-centre European study of breakthrough cancer pain: pain characteristics and patient perceptions of current and potential management strategies

DEFF Research Database (Denmark)

Davies, Andrew; Zeppetella, Giovambattista; Andersen, Steen

2011-01-01

This study involved 320 cancer patients from four Northern European countries. Patients with breakthrough pain were questioned about the characteristics of their pain, the current management of their pain, and the acceptability/utility of alternative routes of administration. The median number...... of episodes was 3/day. Forty-four percent patients reported incident-type pain, 39% spontaneous-type pain, and 17% a combination of these pains. The median duration was 60 min, and the median time to peak intensity was 15 min. Three percent patients reported "mild" pain, 37% "moderate" pain, and 60% "severe......" pain. Ninety percent patients stated that the pain interfered with their daily activities. All patients were using opioids as rescue medication (mainly oral morphine/oxycodone), whilst 28% patients were using non-opioids, and 50% patients were using non-pharmacological interventions. Only 55% patients...

Internet-based data inclusion in a population-based European collaborative follow-up study of inflammatory bowel disease patients: description of methods used and analysis of factors influencing response rates.

Science.gov (United States)

Wolters, Frank L; van Zeijl, Gilbert; Sijbrandij, Jildou; Wessels, Frederik; O'Morain, Colm; Limonard, Charles; Russel, Maurice G; Stockbrugger, Reinhold W

2005-12-07

To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease (IBD) patients and to investigate the influence of demographic and disease related patient characteristics on response rates. Thirteen years ago, the European Collaborative study group of IBD (EC-IBD) initiated a population-based prospective inception cohort of 2 201 uniformly diagnosed IBD patients within 20 well-described geographical areas in 11 European countries and Israel. For the 10-year follow-up of this cohort, an electronic patient questionnaire (ePQ) and electronic physician per patient follow-up form (ePpPFU) were designed as two separate data collecting instruments and made available through an Internet-based website. Independent demographic and clinical determinants of ePQ participation were analyzed using multivariate logistic regression. In 958 (316 CD and 642 UC) out of a total number of 1 505 (64%) available IBD patients, originating from 13 participating centers from nine different countries, both ePQ and ePpPFU were completed. Patients older than 40 years at ePQ completion (OR: 1.53 (95%CI: 1.14-2.05)) and those with active disease during the 3 mo previous to ePQ completion (OR: 3.32 (95%CI: 1.57-7.03)) were significantly more likely to respond. An Internet-based data acquisition tool appeared successful in sustaining a unique Western-European and Israelian multi-center 10-year clinical follow-up study project in patients afflicted with IBD.

The European Cystic Fibrosis Society Patient Registry: valuable lessons learned on how to sustain a disease registry.

Science.gov (United States)

Viviani, Laura; Zolin, Anna; Mehta, Anil; Olesen, Hanne Vebert

2014-06-07

Disease registries have the invaluable potential to provide an insight into the natural history of the disease under investigation, to provide useful information (e.g. through health indicators) for planning health care services and to identify suitable groups of patients for clinical trials enrolment. However, the establishment and maintenance of disease registries is a burdensome initiative from economical and organisational points of view and experience sharing on registries management is important to avoid waste of resources. The aim of this paper is to discuss the problems embedded in the institution and management of an international disease registry to warn against common mistakes that can derail the best of intentions: we share the experience of the European Cystic Fibrosis Society Patient Registry, which collects data on almost 30,000 patients from 23 countries. We discuss the major problems that researchers often encounter in the creation and management of disease registries: definition of the aims the registry has to reach, definition of the criteria for patients referral to the registry, definition of the information to record, set up of a data quality process, handling of missing data, maintenance of data confidentiality, regulation of data use and dissemination of research results. We give examples on how many crucial aspects were solved by the European Cystic Fibrosis Society Patient Registry regarding objectives, inclusion criteria and variables definition, data management, data quality controls, missing data handling, confidentiality maintenance, data use and results dissemination. We suggest an extensive literature research and discussions in working groups with different stake holders, including patient representatives, on the objectives, inclusion criteria and the information to record. We propose to pilot the recording of few variables and test the applicability of their definition first. The use of a shared electronic platform for data

AP@home: a novel European approach to bring the artificial pancreas home.

Science.gov (United States)

Heinemann, Lutz; Benesch, Carsten; DeVries, J Hans

2011-11-01

The development of an artificial pancreas (AP) made huge strides from 2006 to 2008 and a large number of activities are going on in this area of research. Until now, most AP systems under development were tested only under highly controlled conditions. The aim of our project, funded by the European Union, is to develop an AP system to such a level that it can be studied under daily life conditions at the home of patients with diabetes (hence AP@home). Based on a subcutaneous-subcutaneous closed-loop strategy (i.e., glucose sensing and insulin infusion in the subcutaneous tissue), two different approaches will be taken to achieve this aim: a two-port AP system and a single-port AP system. The two-port AP system will use off-the-shelf-components for the glucose sensor and insulin pump in combination with closed-loop algorithms generated in Europe. As to the single-port AP system, two different innovative single-port systems will be developed; in this case, continuous glucose monitoring and insulin infusion will take place via a single catheter. The first clinical trials with the two-port AP system under controlled clinical conditions have started and good progress has been made in the development of the single-port AP systems. We believe that our consortium of 12 European partners, which builds on existing achievements and close cooperation between academic centers and industry, can contribute substantially to the development of an AP system that can be used by patients in daily life. © 2011 Diabetes Technology Society.

Low social interactions in eating disorder patients in childhood and adulthood: a multi-centre European case control study.

Science.gov (United States)

Krug, Isabel; Penelo, Eva; Fernandez-Aranda, Fernando; Anderluh, Marija; Bellodi, Laura; Cellini, Elena; di Bernardo, Milena; Granero, Roser; Karwautz, Andreas; Nacmias, Benedetta; Ricca, Valdo; Sorbi, Sandro; Tchanturia, Kate; Wagner, Gudrun; Collier, David; Treasure, Janet

2013-01-01

The objective of this article was to examine lifestyle behaviours in eating disorder (ED) patients and healthy controls. A total of 801 ED patients and 727 healthy controls from five European countries completed the questions related to lifestyle behaviours of the Cross-Cultural Questionnaire (CCQ). For children, the ED sample exhibited more solitary activities (rigorously doing homework [psocializing with friends [pgroup and this continued in adulthood. There were minimal differences across ED sub-diagnoses and various cross-cultural differences emerged. Reduced social activities may be an important risk and maintaining factor for ED symptomatology.

Analysing data from patient-reported outcome and quality of life endpoints for cancer clinical trials: a start in setting international standards.

Science.gov (United States)

Bottomley, Andrew; Pe, Madeline; Sloan, Jeff; Basch, Ethan; Bonnetain, Franck; Calvert, Melanie; Campbell, Alicyn; Cleeland, Charles; Cocks, Kim; Collette, Laurence; Dueck, Amylou C; Devlin, Nancy; Flechtner, Hans-Henning; Gotay, Carolyn; Greimel, Eva; Griebsch, Ingolf; Groenvold, Mogens; Hamel, Jean-Francois; King, Madeleine; Kluetz, Paul G; Koller, Michael; Malone, Daniel C; Martinelli, Francesca; Mitchell, Sandra A; Moinpour, Carol M; Musoro, Jammbe; O'Connor, Daniel; Oliver, Kathy; Piault-Louis, Elisabeth; Piccart, Martine; Pimentel, Francisco L; Quinten, Chantal; Reijneveld, Jaap C; Schürmann, Christoph; Smith, Ashley Wilder; Soltys, Katherine M; Taphoorn, Martin J B; Velikova, Galina; Coens, Corneel

2016-11-01

Measures of health-related quality of life (HRQOL) and other patient-reported outcomes generate important data in cancer randomised trials to assist in assessing the risks and benefits of cancer therapies and fostering patient-centred cancer care. However, the various ways these measures are analysed and interpreted make it difficult to compare results across trials, and hinders the application of research findings to inform publications, product labelling, clinical guidelines, and health policy. To address these problems, the Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative has been established. This consortium, directed by the European Organisation for Research and Treatment of Cancer (EORTC), was convened to provide recommendations on how to standardise the analysis of HRQOL and other patient-reported outcomes data in cancer randomised trials. This Personal View discusses the reasons why this project was initiated, the rationale for the planned work, and the expected benefits to cancer research, patient and provider decision making, care delivery, and policy making. Copyright © 2016 Elsevier Ltd. All rights reserved.

Treatment Dosing Patterns and Clinical Outcomes for Patients with Type 2 Diabetes Starting or Switching to Treatment with Insulin Glargine (300 Units per Milliliter) in a Real-World Setting: A Retrospective Observational Study.

Science.gov (United States)

Gupta, Shaloo; Wang, Hongwei; Skolnik, Neil; Tong, Liyue; Liebert, Ryan M; Lee, Lulu K; Stella, Peter; Cali, Anna; Preblick, Ronald

2018-01-01

Usage patterns and effectiveness of a longer-acting formulation of insulin glargine at a strength of 300 units per milliliter (Gla-300) have not been studied in real-world clinical practice. This study evaluated differences in dosing and clinical outcomes before and after Gla-300 treatment initiation in patients with type 2 diabetes starting or switching to treatment with Gla-300 to assess whether the benefits observed in clinical trials translate into real-world settings. This was a retrospective observational study using medical record data obtained by physician survey for patients starting treatment with insulin glargine at a strength of 100 units per milliliter (Gla-100) or Gla-300, or switching to treatment with Gla-300 from treatment with another basal insulin (BI). Differences in dosing and clinical outcomes before versus after treatment initiation or switching were examined by generalized linear mixed-effects models. Among insulin-naive patients starting BI treatment, no difference in the final titrated dose was observed in patients starting Gla-300 treatment versus those starting Gla-100 treatment [least-squares (LS) mean 0.43 units per kilogram vs 0.44 units per kilogram; P = 0.77]. Both groups had significant hemoglobin A 1c level reductions (LS mean 1.21 percentage points for Gla-300 and 1.12 percentage points for Gla-100 ; both P per kilogram before switch vs 0.58 units per kilogram after switch; P = 0.02). The mean hemoglobin A 1c level was significantly lower after switching than before switching (adjusted difference - 0.95 percentage points, 95% CI - 1.13 to - 0.78 percentage points ; P per patient-year were significantly lower (relative risk 0.17, 95% CI 0.11-0.26; P < 0.0001). Insulin-naive patients starting Gla-300 treatment had fewer hypoglycemic events, a similar hemoglobin A 1c level reduction, and no difference in insulin dose versus patients starting Gla-100 treatment. Patients switching to Gla-300 treatment from treatment with

THE ROLE OF THE EUROPEAN FUNDING IN THE CONTEXT OF THE ECONOMIC CRISIS

Directory of Open Access Journals (Sweden)

Liliana – Victoria GHERMAN

2013-06-01

Full Text Available The economic crisis from the last period significantly affected the business environment. Despite the progress registered by Romania in the last years, there are some important disparities in the field of competitiveness compared to the European Union member states. It is important to have adequate financial resources for the small and medium enterprises (SMEs and to increase the competitiveness.Companies may obtain European funds for investments in order to improve their activities, starting with the production facilities, procurement of IT equipment and modernization of the tourism infrastructure.The general objective of the Sectoral Operational Programme - “The Increase of Economic Competitiveness” (SOP IEC is to increase the productivity of the Romanian enterprises in order to comply with the European Union principles: long term development and decrease of the disparities.With the support of the European funds it can be reduced the negative impact of the economic crisis.

Influence from genetic variability on opioid use for cancer pain: a European genetic association study of 2294 cancer pain patients

DEFF Research Database (Denmark)

Klepstad, P; Fladvad, T; Skorpen, F

2011-01-01

variability with opioid doses in a large population using a confirmatory validation population was warranted. We recruited 2294 adult European patients using a World Health Organization (WHO) step III opioid and analyzed single nucleotide polymorphisms (SNPs) in genes with a putative influence on opioid...

Cutaneous manifestations in patients with mastocytosis: Consensus report of the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology.

Science.gov (United States)

Hartmann, Karin; Escribano, Luis; Grattan, Clive; Brockow, Knut; Carter, Melody C; Alvarez-Twose, Ivan; Matito, Almudena; Broesby-Olsen, Sigurd; Siebenhaar, Frank; Lange, Magdalena; Niedoszytko, Marek; Castells, Mariana; Oude Elberink, Joanna N G; Bonadonna, Patrizia; Zanotti, Roberta; Hornick, Jason L; Torrelo, Antonio; Grabbe, Jürgen; Rabenhorst, Anja; Nedoszytko, Boguslaw; Butterfield, Joseph H; Gotlib, Jason; Reiter, Andreas; Radia, Deepti; Hermine, Olivier; Sotlar, Karl; George, Tracy I; Kristensen, Thomas K; Kluin-Nelemans, Hanneke C; Yavuz, Selim; Hägglund, Hans; Sperr, Wolfgang R; Schwartz, Lawrence B; Triggiani, Massimo; Maurer, Marcus; Nilsson, Gunnar; Horny, Hans-Peter; Arock, Michel; Orfao, Alberto; Metcalfe, Dean D; Akin, Cem; Valent, Peter

2016-01-01

Cutaneous lesions in patients with mastocytosis are highly heterogeneous and encompass localized and disseminated forms. Although a classification and criteria for cutaneous mastocytosis (CM) have been proposed, there remains a need to better define subforms of cutaneous manifestations in patients with mastocytosis. To address this unmet need, an international task force involving experts from different organizations (including the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology) met several times between 2010 and 2014 to discuss the classification and criteria for diagnosis of cutaneous manifestations in patients with mastocytosis. This article provides the major outcomes of these meetings and a proposal for a revised definition and criteria. In particular, we recommend that the typical maculopapular cutaneous lesions (urticaria pigmentosa) should be subdivided into 2 variants, namely a monomorphic variant with small maculopapular lesions, which is typically seen in adult patients, and a polymorphic variant with larger lesions of variable size and shape, which is typically seen in pediatric patients. Clinical observations suggest that the monomorphic variant, if it develops in children, often persists into adulthood, whereas the polymorphic variant may resolve around puberty. This delineation might have important prognostic implications, and its implementation in diagnostic algorithms and future mastocytosis classifications is recommended. Refinements are also suggested for the diagnostic criteria of CM, removal of telangiectasia macularis eruptiva perstans from the current classification of CM, and removal of the adjunct solitary from the term solitary mastocytoma. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Patients' perceptions of information and education for renal replacement therapy: an independent survey by the European Kidney Patients' Federation on information and support on renal replacement therapy.

Directory of Open Access Journals (Sweden)

Wim Van Biesen

Full Text Available Selection of an appropriate renal replacement modality is of utmost importance for patients with end stage renal disease. Previous studies showed provision of information to and free modality choice by patients to be suboptimal. Therefore, the European Kidney Patients' Federation (CEAPIR explored European patients' perceptions regarding information, education and involvement on the modality selection process.CEAPIR developed a survey, which was disseminated by the national kidney patient organisations in Europe.In total, 3867 patients from 36 countries completed the survey. Respondents were either on in-centre haemodialysis (53% or had a functioning graft (38% at the time of survey. The majority (78% evaluated the general information about kidney disease and treatment as helpful, but 39% did not recall being told about alternative treatment options than their current one. Respondents were more often satisfied with information provided on in-centre haemodialysis (90% and transplantation (87% than with information provided on peritoneal dialysis (79% or home haemodialysis (61%, and were more satisfied with information from health care professionals vs other sources such as social media. Most (75% felt they had been involved in treatment selection, 29% perceived they had no free choice. Involvement in modality selection was associated with enhanced satisfaction with treatment (OR 3.13; 95% CI 2.72-3.60. Many respondents (64% could not remember receiving education on how to manage their kidney disease in daily life. Perceptions on information seem to differ between countries.Kidney patients reported to be overall satisfied with the information they received on their disease and treatment, although information seemed mostly to have been focused on one modality. Patients involved in modality selection were more satisfied with their treatment. However, in the perception of the patients, the freedom to choose an alternative modality showed room for

European Utility Requirements: European nuclear energy

International Nuclear Information System (INIS)

Komsi, M.; Patrakka, E.

1997-01-01

The work procedure and the content of the European Utility Requirements (EUR) concerning the future LWRs is described in the article. European Utility Requirements, produced by utilities in a number of European countries, is a document specifying the details relating to engineered safety, operating performance, reliability and economics of the reactors to be built by manufacturers for the European market

The European quantum technologies flagship programme

Science.gov (United States)

Riedel, Max F.; Binosi, Daniele; Thew, Rob; Calarco, Tommaso

2017-09-01

Quantum technologies, such as quantum communication, computation, simulation as well as sensors and metrology, address and manipulate individual quantum states and make use of superposition and entanglement. Both companies and governments have realised the high disruptive potential of this technology. Consequently, the European Commission has announced an ambitious flagship programme to start in 2018. Here, we sum up the history leading to the quantum technologies flagship programme and outline its envisioned goals and structure. We also give an overview of the strategic research agenda for quantum communication, which the flagship will pursue during its 10-year runtime.

The story of the European fast reactor cooperation

International Nuclear Information System (INIS)

Marth, W.

1993-12-01

This report is a condensed history of European cooperation in the large breeder power plants with powers in excess of 1000 MWe. The beginning, in 1973, was marked by the so-called Utilities' Convention signed by EdF, RWE, and ENEL on the construction of Superphenix and SNR 2. In 1977, cooperation began among the reactor vendors and R and D organizations in France, Germany and Italy as well as Belgium and the Netherlands. After the British had joined in 1984, planning for the European Fast Reactor, EFR, was started in 1988. The conceptual design phase of the 1500 MWe breeder power plant covered a period of five years and was concluded with an economic assessment and a technical safety analysis of EFR in 1983. A number of ongoing studies are being conducted within a specific EFR program. (orig.) [de

GRAPHICAL ANALYSIS OF LAFFER'S THEORY FOR EUROPEAN UNION MEMBER STATES

Directory of Open Access Journals (Sweden)

LILIANA BUNESCU

2013-04-01

Full Text Available Most times the current situation of one or another country depends on the historical development of own tax system. A practical question of any governance is to determine the optimal taxation rate level, bringing to the state the highest tax revenues. A good place to start is with what is popularly known as the Laffer curve. This paper aims to determine in graphical terms the level where European economies ranks by using Laffer curve based on the data series provided by the European Commission and the World Bank. Graphical analysis of Laffer's theory can emphasize only the positioning on one or another side of point for maximum tax revenues, a position that can influence fiscal policy decisions. Conclusions at European Union level are simple. Value of taxation rate for fiscal optimal point varies from one Member State to another, from 48.9% in Denmark to 28% in Romania, with an average of 37.1% for the EU-27.

The European reliability data system. An organized information exchange on the operation of European nuclear reactors

International Nuclear Information System (INIS)

Mancini, G.; Amesz, J.; Bastianini, P.; Capobianchi, S.

1983-01-01

The paper revises the aims and objectives of the European Reliability Data System (ERDS), a centralized system collecting and organizing, at European level, information related to the operation of LWRs. The ERDS project was started in 1977 and after a preliminary feasibility study that ended in 1979 is now proceeding towards the final design and implementation stages. ERDS exploits information collected in national data systems and information deriving from single reactor sources. The paper describes first the development of the four data banks constituting the system: Component Event Data Bank, CEDB; Abnormal Occurrences Reporting System, AORS; Operating Unit Status Report, OUSR; and Generic Reliability Parameter Data Bank, GRPDB. Several typical aspects concerning the project are then outlined from the need of homogeneization of data and therefore the need for setting up reference classifications, to the problem of data transcoding and input into the system. Furthermore, the need is stressed of involving much more deeply nuclear power plant operators into the process of data acquisition by providing them with a useful feedback from the data analysis. (author)

Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients

DEFF Research Database (Denmark)

Chatzidionysiou, Katerina; Lie, Elisabeth; Nasonov, Evgeny

2012-01-01

is an effective and safe alternative to methotrexate as concomitant treatment with rituximab. Slightly better results were obtained by the combination of rituximab and leflunomide than rituximab and methotrexate, raising the possibility of a synergistic effect of leflunomide and rituximab.......OBJECTIVES: To compare the effectiveness and safety of rituximab alone or in combination with either methotrexate or leflunomide.METHODS: 10 European registries submitted anonymised datasets with baseline, 3, 6, 9 and 12-month clinical data from patients who started rituximab.RESULTS: 1195 patients...

Directional preference and functional outcomes among subjects classified at high psychosocial risk using STarT.

Science.gov (United States)

Werneke, Mark W; Edmond, Susan; Young, Michelle; Grigsby, David; McClenahan, Brian; McGill, Troy

2018-03-14

Physiotherapy has an important role in managing patients with non-specific low back pain who experience elevated psychosocial distress or risk for chronic disability. In terms of evidence-based physiotherapy practice, cognitive-behavioural approaches for patients at high psychosocial risk are the recommended management to improve patient treatment outcomes. Evidence also suggests that directional preference (DP) is an important treatment effect modifier for prescribing specific exercises for patients to improve outcomes. Little is known about the influence of treatment techniques based on DP on outcomes for patients classified as high psychosocial risk using the Subgroups for Targeted Treatment (STarT) Back Screening Tool. This study aimed to examine the association between functional status (FS) at rehabilitation discharge for patients experiencing low back pain classified at high STarT psychosocial risk and whose symptoms showed a DP versus No-DP. High STarT risk patients (n = 138) completed intake surveys, that is, the lumbar FS of Focus On Therapeutic Outcomes, Inc., and STarT, and were evaluated for DP by physiotherapists credentialed in McKenzie methods. The FS measure of Focus On Therapeutic Outcomes, Inc., was repeated at discharge. DP and No-DP prevalence rates were calculated. Associations between first-visit DP and No-DP and change in FS were assessed using univariate and multivariate regression models controlling for 11 risk-adjusted variables. One hundred nine patients classified as high STarT risk had complete intake and discharge FS and DP data. Prevalence rate for DP was 65.1%. A significant and clinically important difference (7.98 FS points; p = .03) in change in function at discharge between DP and No-DP was observed after controlling for all confounding variables in the final model. Findings suggest that interventions matched to DP are effective for managing high psychological risk patients and may provide physiotherapists with an

European consensus statement on diagnosis and treatment of adult ADHD: the European Network adult ADHD

LENUS (Irish Health Repository)

Kooij, Sandra JJ

2010-09-03

Abstract Background Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. Methods The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. Results Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? Conclusions ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group.

Emergency Department Length of Stay for Maori and European Patients in New Zealand.

Science.gov (United States)

Prisk, David; Godfrey, A Jonathan R; Lawrence, Anne

2016-07-01

Emergency department length of stay (ED LOS) is currently used in Australasia as a quality measure. In our ED, Maori, the indigenous people of New Zealand, have a shorter ED LOS than European patients. This is despite Maori having poorer health outcomes overall. This study sought to determine drivers of LOS in our provincial New Zealand ED, particularly looking at ethnicity as a determining factor. This was a retrospective cohort study that reviewed 80,714 electronic medical records of ED patients from December 1, 2012, to December 1, 2014. Univariate and multivariate analyses were carried out on raw data, and we used a complex regression analysis to develop a predictive model of ED LOS. Potential covariates were patient factors, temporal factors, clinical factors, and workload variables (volume and acuity of patients three hours prior to and two hours after presentation by a baseline patient). The analysis was performed using R studio 0.99.467. Ethnicity dropped out in the stepwise regression procedure; after adjusting for other factors, a specific ethnicity effect was not informative. Maori were, on average, younger, less likely to receive bloodwork and radiographs, less likely to go to our observation area, less likely to have a general practitioner, and more likely to be discharged and to self-discharge; all of these factors decreased their length of stay. Length of stay in our ED does not seem to be related to ethnicity alone. Patient factors had only a small impact on ED LOS, while clinical factors, temporal factors, and workload variables had much greater influence.

How European public relations men and women perceive the impact of their professional activities

NARCIS (Netherlands)

Verhoeven, P.; Aarts, N.

2010-01-01

Starting from the theoretical perspective of gendered discourses, a secondary analysis of the data from the European Communication Monitors of 2008 and 2009, an annual survey about trends in the profession of public relations, was conducted on gender differences. The pilot study shows that female

Later Start, Longer Sleep: Implications of Middle School Start Times

Science.gov (United States)

Temkin, Deborah A.; Princiotta, Daniel; Ryberg, Renee; Lewin, Daniel S.

2018-01-01

Background: Although adolescents generally get less than the recommended 9 hours of sleep per night, research and effort to delay school start times have generally focused on high schools. This study assesses the relation between school start times and sleep in middle school students while accounting for potentially confounding demographic…

European symposium on precision medicine in allergy and airways diseases

DEFF Research Database (Denmark)

Muraro, A; Fokkens, W J; Pietikainen, S

2015-01-01

suffering from allergies and asthma, more than half of these patients are deprived from adequate diagnosis and treatment. Precision Medicine represents a novel approach in medicine, embracing 4 key features: personalized care based on molecular, immunologic and functional endotyping of the disease......On 14 October 2015, the European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS) and the European Medical Association (EMA) organized a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP......, with participation of the patient in the decision making process of therapeutic actions, and taking into account predictive and preventive aspects of the treatment. Implementation of Precision Medicine into clinical practice may help to achieve the arrest of the Epidemic of Allergies and Chronic Airways Diseases...

Purchasing health services abroad: practices of cross-border contracting and patient mobility in six European countries.

Science.gov (United States)

Glinos, Irene A; Baeten, Rita; Maarse, Hans

2010-05-01

Contracting health services outside the public, statutory health system entails purchasing capacity from domestic non-public providers or from providers abroad. Over the last decade, these practices have made their way into European health systems, brought about by performance-oriented reforms and EU principles of free movement. The aim of the article is to explain the development, functioning, purposes and possible implications of cross-border contracting. Primary and secondary sources on purchasing from providers abroad have been collected in a systematic way and analysed in a structured frame. We found practices in six European countries. The findings suggest that purchasers from benefit-in-kind systems contract capacity abroad when this responds to unmet demand; pressures domestic providers; and/or offers financial advantages, especially where statutory purchasers compete. Providers which receive patients tend to be located in countries where treatment costs are lower and/or where providers compete. The modalities of purchasing and delivering care abroad vary considerably depending on contracts being centralised or direct, the involvement of middlemen, funding and pricing mechanisms, cross-border pathways and volumes of patient flows. The arrangements and concepts which cross-border contracting relies on suggest that statutory health purchasers, under pressure to deliver value for money and striving for cost-efficiency, experiment with new ways of organising health services for their populations. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Large scale solar thermal power for the European Union{exclamation_point}

Energy Technology Data Exchange (ETDEWEB)

Anon.

1997-06-01

Southern Europe, on the edge of the sunbelt, represents the ideal location for solar thermal generated power. Last year. SAWIE reported on the THESEUS project, a proposed 50 MWe solar thermal power plant for Frangokastello, southern Crete, which was submitted for support under the European Union`s THERMIE Programme. Funding was approved for the design phase for this innovative power plant, the first large-scale SEGS-style plant on European soil, at the end of last year. However, the THERMIE Programme also provided support for another Southern European plant, proposed by Colon Solar for Huelva in Southern Spain. Whilst hurdles remain to be overcome before both plants are built and commissioned, there is an excellent chance that by the start of the new Millennium, the solar collectors from these two plants could be generating over half a million MWh of energy a year. SAWIE compares the two projects. (author)

Cost-effectiveness evaluation of clobetasol propionate shampoo (CPS) maintenance in patients with moderate scalp psoriasis: a Pan-European analysis.

Science.gov (United States)

Papp, K; Poulin, Y; Barber, K; Lynde, C; Prinz, J C; Berg, M; Kerrouche, N; Rives, V P

2012-11-01

Scalp psoriasis is a difficult to treat and usually chronic manifestation of psoriasis. The CalePso study showed that CPS (Clobex(®) Shampoo) in maintenance therapy of scalp psoriasis (twice weekly) significantly increases the probability of keeping patient under remission during 6 months, compared with vehicle (40.3% relapses vs. 11.6% relapses, ITT). The objective of the study was to assess the cost-effectiveness of a maintenance therapy with CPS vs. its vehicle in nine European countries. A 24-week decision tree model was developed with 4-weekly time steps. The considered population has moderate scalp psoriasis successfully treated with a daily application of CPS up to 4 weeks. Data were taken from the CalePso study and from national experts' recommendations for alternative treatment choices, with their probabilities of success taken from literature to develop country-specific models. Health benefits are measured in disease-free days (DFD). The economic analysis includes drug and physician costs. A probabilistic sensitivity analysis (PrSA) assesses the uncertainty of the model. Depending on the country, the mean total number of DFDs per patient is 21-42% higher with CPS compared with vehicle, and the mean total cost is 11-31% lower. The mean costs per DFD are 30-46% lower with CPS compared with the vehicle. The PrSA showed in 1000 simulations that CPS is more effective vs. vehicle in 100% of the cases and less expensive than its vehicle in 80-99% of the cases. This model suggests that CPS is cost-effective in maintaining the success achieved in moderate scalp psoriasis patients. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

The European Network of Coloproctology: a strategy towards the European research and healthcare system.

Science.gov (United States)

Rubbini, Michele

2016-12-01

Many documents from the International Institutions point out that Health represents an engine of economic and social development. Based on these documents and concepts, the European Parliament decided to create a system of European Reference Networks as a synthesis of clinical and research activities, particularly in the field of rare diseases. This initiative, properly implemented, could be first step towards a new European health system. This article instead, wanting to deepen this perspective, postulates that the ERNs may also be related to widespread diseases, such as those of coloproctological interest, with the aim of setting up a European Network of Coloproctology (ENCP). Here are analyzed: (a) the documents related to ERNs and others related to research and training, the characteristics of the coloproctological diseases, and proposal of the ENCP; (b) a survey that involves 14 out of 25 of the National and Regional Representative of the European Society of Coloproctology. Hundred percent of the people interviewed agree to the ENCP project. The percentage of the approved proposed fields of activity of the ENCP are: Healthcare 71%, Research 100%, Training 86%, Support to legislation 78%, Professional Mobility 64%, Patient Database 71%, and Expenditure control 64%. From the analysis of the documents and the result of the survey, ERNs are appropriate not only in relation to rare diseases but also in those fields with higher diffusion and the creation of a European Network of Coloproctology is then postulated.

The European nuclear industry - an overview

International Nuclear Information System (INIS)

Berke, Claus

1994-01-01

In his talk, the President of Foratom, Dr. Claus Berke, reviews the present state of the nuclear industry in Europe. The European nuclear park is still the largest of any region in the world. In some countries, there has been a moratorium on new construction in recent years. This has made life for the supplying industry very difficult. One positive side-effect o at has been a significant rationalisation of the industry. In the course of this the previous vertical integration within European states has given place to the creation of important new transnational structures. In his talk, Dr. Berke describes some of the most important facets of the 'Europeanisation' of the industry, both in the area of power-plants and of the nuclear fuel-cycle. He also describes the increasing cooperation between utilities and suppliers in Western Europe and the operators of nuclear power plant in Eastern Europe, which is aimed at introducing a safety culture and an institutional framework in the East as close as possible to that which exists in Western Europe. Dr. Berke concludes that, over the coming years, both economic and environmental arguments will start to reverse the present political opposition, in many European countries, to new building programmes, and that the industry is likely be in a healthier state by the end of the decade

Switching from NPH insulin to once-daily insulin detemir in basal-bolus-treated patients with diabetes mellitus: data from the European cohort of the PREDICTIVE study.

LENUS (Irish Health Repository)

Sreenan, S

2008-12-01

The PREDICTIVE study is a multinational observational study designed to follow up patients with diabetes who started insulin detemir (IDet) in routine care. Recruitment started in June 2004 and is ongoing in some countries.

EUROPEAN UNION POLICIES FOR CLIMATE CHANGE MITIGATION

Directory of Open Access Journals (Sweden)

Paul Canter

2017-07-01

Full Text Available Climate change is one of the most important challenges that humanity faces in the 21st century, and for the European Union, combating this phenomenon represents an important element, which is reflected both in the actions carried out in recent years, domestically and internationally, as well as in the EU policy on climate change. Within the EU, regulations were adopted, that demonstrate the importance that the Union confers to the limitation of this phenomenon, stressing at the same time the need for an integrated policy framework to ensure the security for potential investors and a coordinated approach between Member States. This paper will present recent developments for the most important policies to combat and mitigate climate change in the European Union, starting with "20-20-20" objectives, which are to be met through the package "Energy-Climate Change", continuing with 2030 and 2050 timeframes, and finally presenting the main lines of action to combat climate change.

Fiscal aspects of the European monetary integration

Directory of Open Access Journals (Sweden)

Golubović Srđan

2014-01-01

Full Text Available Along with the introduction of the euro as a single currency, importance of respecting the fiscal aspects which determine longevity of the monetary arrangement is recognized. For this reason, although underdeveloped, the EU fiscal system provides mechanisms to ensure fiscal discipline among member states. In addition to the fulfillment of the convergence criteria which is a precondition for joining the monetary union, they include no bailout clause and monetary financing prohibition. Sovereign debt that escalated in 2010 showed all the imperfections of these arrangements and pointed to the need for introduction of new and more effective fiscal rules. With fiscal system of the European Union as a starting point, the paper analyzes instruments defined by the fiscal system of the Union, which purpose is to ensure fiscal discipline of the European Monetary Union member states. Last part of the paper analyze new fiscal rules introduced as a response to the debt crisis in the Eurozone.

Breast cancer surgery and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

Science.gov (United States)

Scheller-Kreinsen, David; Quentin, Wilm; Geissler, Alexander; Busse, Reinhard

2013-10-01

Researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with breast cancer surgery patients. DRG algorithms and indicators of resource consumption were assessed for those DRGs that individually contain at least 1% of all breast cancer surgery patients. Six standardised case vignettes were defined and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems classify breast cancer surgery patients according to different sets of classification variables into three to seven DRGs. Quasi prices for an index case treated with partial mastectomy range from €577 in Poland to €5780 in the Netherlands. Countries award their highest payments for very different kinds of patients. Breast cancer specialists and national DRG authorities should consider how other countries' DRG systems classify breast cancer patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. Copyright © 2012 Elsevier Ltd. All rights reserved.

European trauma guideline compliance assessment: the ETRAUSS study.

Science.gov (United States)

Hamada, Sophie Rym; Gauss, Tobias; Pann, Jakob; Dünser, Martin; Leone, Marc; Duranteau, Jacques

2015-12-08

Haemorrhagic shock is the leading cause of preventable death in trauma patients. The 2013 European trauma guidelines emphasise a comprehensive, multidisciplinary, protocol-based approach to trauma care. The aim of the present Europe-wide survey was to compare 2015 practice with the 2013 guidelines. A group of members of the Trauma and Emergency Medicine section of the European Society of Intensive Care Medicine developed a 50-item questionnaire based upon the core recommendations of the 2013 guidelines, employing a multistep approach. The questionnaire covered five fields: care structure and organisation, haemodynamic resuscitation targets, fluid management, transfusion and coagulopathy, and haemorrhage control. The sampling used a two-step approach comprising initial purposive sampling of eminent trauma care providers in each European country, followed by snowball sampling of a maximum number of trauma care providers. A total of 296 responses were collected, 243 (81 %) from European countries. Those from outside the European Union were excluded from the analysis. Approximately three-fourths (74 %) of responders were working in a designated trauma centre. Blunt trauma predominated, accounting for more than 90 % of trauma cases. Considerable heterogeneity was observed in all five core aspects of trauma care, along with frequent deviations from the 2013 guidelines. Only 92 (38 %) of responders claimed to comply with the recommended systolic blood pressure target, and only 81 (33 %) responded that they complied with the target pressure in patients with traumatic brain injury. Crystalloid use was predominant (n = 209; 86 %), and vasopressor use was frequent (n = 171, 76 %) but remained controversial. Only 160 respondents (66 %) declared that they used tranexamic acid always or often. This is the first European trauma survey, to our knowledge. Heterogeneity is significant across centres with regard to the clinical protocols for trauma patients and as to locally

Acquits communautaire in quality management in the energy sector -Central and Eastern European Countries

International Nuclear Information System (INIS)

Ristikj, Julija

1997-01-01

Energy is considered as one of the main infrastructure components, and efficient energy sectors are corner stones for the economic growth of the Central and Eastern European Countries on their way towards gaining EU membership. Therefore, energy is considered as one of the main directions of action within the PHARE Programme with trans-European dimensions. Five years ago started the implementation of the PHARE Multi-country Energy Programme, the efforts of which have been oriented to three main strategic axes: energy policy, energy supply, as well as energy efficiency and environment. (author)

Standard contract terms regulation in the proposal for a common European sales law

NARCIS (Netherlands)

Loos, M.B.M.

2012-01-01

In this paper, the regulation in standard contract terms in the proposal for a Commono European Sales Law (CESL) is compared with the regulation in the Unfair Terms Directive, the Draft Common Frame of Reference (DCFR) and the Vienna Sales Convention (CISG). The paper starts with an overview of the

European inter-institutional impact study of MammaPrint

NARCIS (Netherlands)

Cusumano, P. G.; Generali, D.; Ciruelos, E.; Manso, L.; Ghanem, I.; Lifrange, E.; Jerusalem, G.; Klaase, J.; de Snoo, F.; Stork-Sloots, L.; Dekker-Vroling, L.; Holzik, M. Lutke

Aim: To measure the impact of MammaPrint on adjuvant treatment decisions and to analyze the agreement in treatment decisions between hospitals from 4 European countries for the same patient cohort. Methods: Breast cancer patients were prospectively enrolled and MammaPrint was assessed. Patients'

The Impact of Institutional Settings on Learning Behavior by Venture Capitalists and Start-Ups

DEFF Research Database (Denmark)

Gatti, Anna; Vendelø, Morten Thanning

2005-01-01

differen-ces in local institutional settings affect learning and adaptation by European venture ca-pitalists and start-ups, and thus, affect the processes of field formation. For example, it has been observed that institutional settings can facilitate or discourage learning from direct experience (Herriot...... is to understand if and how US venture capitalism affect the evolvement of venture capitalism in Europe. We study the emergence of a venture capitalist industry in Denmark and Italy, and thus, by selecting two countries with distinctive differences in cultures and institutions, we study learning and adaptation...

A novel approach to delayed-start analyses for demonstrating disease-modifying effects in Alzheimer's disease.

Directory of Open Access Journals (Sweden)

Hong Liu-Seifert

Full Text Available One method for demonstrating disease modification is a delayed-start design, consisting of a placebo-controlled period followed by a delayed-start period wherein all patients receive active treatment. To address methodological issues in previous delayed-start approaches, we propose a new method that is robust across conditions of drug effect, discontinuation rates, and missing data mechanisms. We propose a modeling approach and test procedure to test the hypothesis of noninferiority, comparing the treatment difference at the end of the delayed-start period with that at the end of the placebo-controlled period. We conducted simulations to identify the optimal noninferiority testing procedure to ensure the method was robust across scenarios and assumptions, and to evaluate the appropriate modeling approach for analyzing the delayed-start period. We then applied this methodology to Phase 3 solanezumab clinical trial data for mild Alzheimer's disease patients. Simulation results showed a testing procedure using a proportional noninferiority margin was robust for detecting disease-modifying effects; conditions of high and moderate discontinuations; and with various missing data mechanisms. Using all data from all randomized patients in a single model over both the placebo-controlled and delayed-start study periods demonstrated good statistical performance. In analysis of solanezumab data using this methodology, the noninferiority criterion was met, indicating the treatment difference at the end of the placebo-controlled studies was preserved at the end of the delayed-start period within a pre-defined margin. The proposed noninferiority method for delayed-start analysis controls Type I error rate well and addresses many challenges posed by previous approaches. Delayed-start studies employing the proposed analysis approach could be used to provide evidence of a disease-modifying effect. This method has been communicated with FDA and has been

Differential gene expression between African American and European American colorectal cancer patients.

Directory of Open Access Journals (Sweden)

Biljana Jovov

Full Text Available The incidence and mortality of colorectal cancer (CRC is higher in African Americans (AAs than other ethnic groups in the U. S., but reasons for the disparities are unknown. We performed gene expression profiling of sporadic CRCs from AAs vs. European Americans (EAs to assess the contribution to CRC disparities. We evaluated the gene expression of 43 AA and 43 EA CRC tumors matched by stage and 40 matching normal colorectal tissues using the Agilent human whole genome 4x44K cDNA arrays. Gene and pathway analyses were performed using Significance Analysis of Microarrays (SAM, Ten-fold cross validation, and Ingenuity Pathway Analysis (IPA. SAM revealed that 95 genes were differentially expressed between AA and EA patients at a false discovery rate of ≤5%. Using IPA we determined that most prominent disease and pathway associations of differentially expressed genes were related to inflammation and immune response. Ten-fold cross validation demonstrated that following 10 genes can predict ethnicity with an accuracy of 94%: CRYBB2, PSPH, ADAL, VSIG10L, C17orf81, ANKRD36B, ZNF835, ARHGAP6, TRNT1 and WDR8. Expression of these 10 genes was validated by qRT-PCR in an independent test set of 28 patients (10 AA, 18 EA. Our results are the first to implicate differential gene expression in CRC racial disparities and indicate prominent difference in CRC inflammation between AA and EA patients. Differences in susceptibility to inflammation support the existence of distinct tumor microenvironments in these two patient populations.

The Liability of European States for Climate Change

Directory of Open Access Journals (Sweden)

Roger H J Cox

2014-02-01

Full Text Available According to climate science and the 195 signatory States to the UN Climate Convention, every emission of anthropogenic greenhouse gases contributes to climate change. Furthermore, they hold that a two degree Celsius rise of Earth’s average temperature is to be considered as a dangerous climate change to mankind and all of the world’s ecosystems. Using the climate proceedings of Dutch citizens against the Dutch state as a starting point, the author of this case note explains why each European Member State’s contribution to dangerous climate change as a result of inadequate emission reduction policies constitutes a tort of negligence against its citizens and poses a real threat for its citizens’ effective enjoyment of human rights. The author argues that this makes individual European Nations severally liable for dangerous climate change and gives European citizens and non-governmental organisations the possibility to request their Nation State’s competent court to compel the Nation’s government to implement stricter emission reductions in accordance with what is deemed necessary to help avoid dangerous climate change and to protect their human rights.

New regulatory pathways and incentives for sustainable antibiotics: Recent European & US Initiatives

DEFF Research Database (Denmark)

Minssen, Timo

2014-01-01

) and the COMBACTE and TRANSLOCATION projects under NewDrugs4BadBugs program, involving the EU Commission and the pharma industry. But also national initiatives, such as the successful Danish ban and regulations on antibiotic use in animal production, as well as educational efforts (the European Antibiotic Awareness......New regulatory pathways and incentives for sustainable antibiotics: Recent European & US Initiatives Posted on March 19, 2014 by Timo Minssen Please find attached a ppt presentation on “New regulatory pathways and incentives for sustainable antibiotics: Recent European & US Initiatives” given...... on March 7, 2014 at the Broad Institute of MIT and Harvard. The presentation was followed by a discussion moderated by US patent attorney Melissa Hunter-Ensor, Partner at Saul Ewing, Boston I started out by emphasizing increasing problems of antimicrobial resistance (AMR) on a global level, providing new...

76 FR 37174 - Capital Investment Program-New Starts and Small Starts Program Funds

Science.gov (United States)

2011-06-24

... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Capital Investment Program--New Starts... apportionment of the FY 2011 Capital Investment (New Starts and Small Starts) program funds. The funds will be... FY 2011, $1,596,800,000 was appropriated for the Capital Investments Grant Account, which includes...

Keele Aches and Pains Study protocol: validity, acceptability, and feasibility of the Keele STarT MSK tool for subgrouping musculoskeletal patients in primary care

Directory of Open Access Journals (Sweden)

Campbell P

2016-10-01

Full Text Available Paul Campbell,1 Jonathan C Hill,1 Joanne Protheroe,1 Ebenezer K Afolabi,1 Martyn Lewis,1 Ruth Beardmore,1 Elaine M Hay,1 Christian D Mallen,1 Bernadette Bartlam,1 Benjamin Saunders,1 Danielle A van der Windt,1 Sue Jowett,2 Nadine E Foster,1 Kate M Dunn1 1Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, 2Health Economics Unit, University of Birmingham, Birmingham, UK Abstract: Musculoskeletal conditions represent a considerable burden worldwide, and are predominantly managed in primary care. Evidence suggests that many musculoskeletal conditions share similar prognostic factors. Systematically assessing patient’s prognosis and matching treatments based on prognostic subgroups (stratified care has been shown to be both clinically effective and cost-effective. This study (Keele Aches and Pains Study aims to refine and examine the validity of a brief questionnaire (Keele STarT MSK tool designed to enable risk stratification of primary care patients with the five most common musculoskeletal pain presentations. We also describe the subgroups of patients, and explore the acceptability and feasibility of using the tool and how the tool is best implemented in clinical practice. The study design is mixed methods: a prospective, quantitative observational cohort study with a linked qualitative focus group and interview study. Patients who have consulted their GP or health care practitioner about a relevant musculoskeletal condition will be recruited from general practice. Participating patients will complete a baseline questionnaire (shortly after consultation, plus questionnaires 2 and 6 months later. A subsample of patients, along with participating GPs and health care practitioners, will be invited to take part in qualitative focus groups and interviews. The Keele STarT MSK tool will be refined based on face, discriminant, construct, and predictive validity at baseline and 2

ONTOLOGY MAPPING IN THE RESILIENCE STUDY: THE ORGANIZATIONAL PERSPECTIVE FOR EUROPEAN UNION CASE

Directory of Open Access Journals (Sweden)

Tiberiu-Tudor SALANŢIU

2017-12-01

Full Text Available The ontology mapping in resilience surveillance on organization level can found utilization in analysis of association between idiosyncrasies and structure adaptability. Starting from the data regarding the economic trends for European Union members from 2014 to 2016 the aim of the research is to analyse the European Union resilience through interpretation of the link between members behaviour and structure convergence. The members positioned in European Union was analysed after organization clusterization of the twenty-eight state members. Two different structures are included into analysis for the studied periods: a structure which incorporates just the state members, and other which also take into account the eurozone blue-chips. In order to analyse the members’ relation in structure a gravity model has been developed, the obtained results for each state members pair are contained in a skew matrix. The values are interpreted through a knowledge-base to highlight the European Union resilience degree.

The European climate change program. An evaluation of stakeholder involvement and policy achievements

International Nuclear Information System (INIS)

Maxian Rusche, Tim

2010-01-01

In order to step up its efforts in reducing climate change, the European Commission (hereafter: the Commission) has launched in June 2000 its European climate change program (hereafter: ECCP). This wide-ranging stakeholder consultation aimed at identifying and developing all elements necessary for a European climate change strategy. The ECCP formally came to a close in April 2003. This paper analyses the inner workings of ECCP, and how ECCP has delivered with regard to its objectives. Special attention is paid to ECCP's Working Group 1, 'Flexible Mechanisms', which developed the foundations for the European emission trading scheme (hereafter: EU ETS). The paper draws on documents published on the Commission's ECCP web-site, on academic literature, on press releases from stakeholders and on interviews with four participants in the ECCP process. Using this method, the paper offers important insights as to how the consensus-building for establishing the world's biggest carbon-trading scheme has started long time before the formal legislative process. (author)

Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis.

Science.gov (United States)

Lip, Gregory Y H; Andreotti, Felicita; Fauchier, Laurent; Huber, Kurt; Hylek, Elaine; Knight, Eve; Lane, Deirdre; Levi, Marcel; Marín, Francisco; Palareti, Gualtiero; Kirchhof, Paulus

2011-12-01

In this executive summary of a Consensus Document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in atrial fibrillation (AF) patients. The main aim of the document was to summarise 'best practice' in dealing with bleeding risk in AF patients when approaching antithrombotic therapy, by addressing the epidemiology and size of the problem, and review established bleeding risk factors. We also summarise definitions of bleeding in the published literature. Patient values and preferences balancing the risk of bleeding against thromboembolism as well as the prognostic implications of bleeding are reviewed. We also provide an overview of published bleeding risk stratification and bleeding risk schema. Brief discussion of special situations (e.g. periablation, peri-devices such as implantable cardioverter defibrillators [ICD] or pacemakers, presentation with acute coronary syndromes and/or requiring percutanous coronary interventions/stents and bridging therapy) is made, as well as a discussion of the prevention of bleeds and managing bleeding complications. Finally, this document puts forwards consensus statements that may help to define evidence gaps and assist in everyday clinical practice.

Europeanization process impacts the patterns of alcohol consumption in the Western Balkans.

Science.gov (United States)

Tresa, Eni; Benmarhnia, Tarik; Clemens, Timo; Burazeri, Genc; Czabanowska, Katarzyna

2017-10-20

Western Balkan countries exhibit high levels of alcohol consumption, which constitutes a serious public health concern. We aimed to quantitatively assess the influence of the Europeanization process on levels of alcohol consumption in Western Balkans, an issue that has been under-researched. The process of Europeanization was defined as the penetration of European dimension, procedures, policy paradigms, beliefs and norms in national arenas of politics and policy development. Data about alcohol consumption in six Western Balkan countries from 1991 to 2011 were gathered from the World Bank and World Health Organization databases. Azerbaijan and Georgia were considered control countries. A difference-in-differences approach was used to assess the impact of Europeanization process on levels of alcohol consumption. The Europeanization process impacts alcohol consumption in Western Balkan countries through the European Union directives and tax policies. After starting the Europeanization process, the spirits consumption in Croatia and The Former Yugoslav Republic of Macedonia decreased by 1.06 litter per capita (95% CI: from -1.63 to - 0.49) and 1.02 litter per capita in Serbia (95% CI: from -1.9 to - 0.1). Our analysis provides useful evidence about the possible influence of Europeanization process especially on spirits consumption levels in Western Balkans. These findings draw attention to the need to implement new policies in order to prevent alcohol health-related harm due to the possible increase of wine and beer consumption. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Working towards a European Geological Data Infrastructure

Science.gov (United States)

van der Krogt, Rob; Hughes, Richard; Pedersen, Mikael; Serrano, Jean-Jacques; Lee, Kathryn A.; Tulstrup, Jørgen; Robida, François

2013-04-01

The increasing importance of geological information for policy, regulation and business needs at European and international level has been recognized by the European Parliament and the European Commission, who have called for the development of a common European geological knowledge base. The societal relevance of geoscience data/information is clear from many current issues such as shale gas exploration (including environmental impacts), the availability of critical mineral resources in a global economy, management and security with regard to geohazards (seismic, droughts, floods, ground stability), quality of (ground-)water and soil and societal responses to the impacts of climate change. The EGDI-Scope project responds to this, aiming to prepare an implementation plan for a pan-European Geological Data Infrastructure (EGDI), under the umbrella of the FP7 e- Infrastructures program. It is envisaged that the EGDI will build on geological datasets and models currently held by the European Geological Surveys at national and regional levels, and will also provide a platform for datasets generated by the large number of relevant past, ongoing and future European projects which have geological components. With European policy makers and decision makers from (international) industry as the main target groups (followed by research communities and the general public) stakeholder involvement is imperative to the successful realization and continuity of the EGDI. With these ambitions in mind, the presentation will focus on the following issues, also based on the first results and experiences of the EGDI-Scope project that started mid-2012: • The organization of stakeholder input and commitment connected to relevant 'use cases' within different thematic domains; a number of stakeholder representatives is currently involved, but the project is open to more extensive participation; • A large number of European projects relevant for data delivery to EGDI has been reviewed

Europol’s Cybercrime Centre (EC3), its Agreements with Third Parties and the Growing Role of Law Enforcement on the European Security Scene

DEFF Research Database (Denmark)

Vendius, Trine Thygesen

2015-01-01

The European Cyber Crime Centre, EC3, established under the umbrella of Europol, started operations on January 1 2013. It is to act as the focal point in the fight against cybercrime in the European Union. Using a “shared, cross-community approach” the EC3 is concluding partnerships with member...... states, European agencies, international partners and the private sector. This article describes the coming about of EC3 and its efforts to address cybercrime. Furthermore, the article is an attempt to assess the growing role of the European law enforcement community on the European security scene...

THE EUROPEAN CENTRAL BANK AND THE EUROZONE CRISIS MANAGEMENT

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MONICA ŞAGUNA

2013-05-01

Full Text Available The Euro is the single currency shared by 17 of the European Union's Member States, which together make up the Euro area. Since its introduction, in January 2002, it became the second most traded currency in the world after the United States dollar. With the launch of the Euro, the monetary policy became the responsibility of the independent European Central Bank, which was created for that purpose, and of the national central banks of the Member States, having adopted the Euro. However, the accumulation of massive and unsustainable deficits and public debt levels in a number of peripheral economies threatened the Eurozone's viability by the end of its first decade, triggering a Eurozone sovereign debt crisis. The institutional mechanisms surrounding the Euro have also been an integral part of the crisis. On this line, the European Monetary Union is supported on one side by treaties and multilateral agreements including the Maastricht Treaty, the Stability and Growth Pact and the Lisbon Strategy and, on the other side, by the European Central Bank. The combination of these institutions has produced a mix of monetary, fiscal and labour market policies with powerful social implications. And, what started as a debt crisis in Greece in late 2009 has evolved into a broader economic and political crisis in the Eurozone and European Union. In this framework, the purpose of my paper is to analyze the roots of the Eurozone crisis, as the biggest challenge since the Euro adoption and the European Central Bank’s response to it. Therefore the objectives are: identification of the reasons that stand behind the crisis, then observing how the crisis has affected the functioning of the European Central Bank and the Euro, and how it was forced to respond and, finally, focusing on the future and the challenges that lie ahead.

ERA—European Radiochemists Association: Report on the activities of the Working Party for Nuclear and Radiochemistry of the Federation of European Chemical Societies

Science.gov (United States)

Kolar, Z. I.; Ware, A. R.

2003-01-01

The European Radiochemists Association started almost simultaneously with the appearance of the first issue of the Radiochemistry in Europe newsletter in August 1995. The objective of the European Radiochemists Association (ERA) is to extend and improve communication between radiochemists in Europe through a newsletter. Liaison persons within each country or group exchange details of their activities, set up a diary of relevant international events and exchange details of specialist equipment, facilities and technology. In the year 2000 the Federation of European Chemical Societies decided to form a working party on nuclear and radiochemistry. It is a formalisation of the European Radiochemists Association. Each chemical society is allowed to nominate a member to the Working Party on Nuclear and Radiochemistry. Currently we have 12 nominated members plus two invited and one observer. In addition to the ERA aims and objectives it proposes to put together a syllabus of radiochemistry for undergraduate and post-graduate students—this aspect has been a part of our support of the International Atomic Energy Agency initiative. Also the aim of the working party is to support other working parties and divisions, to press the Federation of the European Chemical Societies for financial structure. To this end an Expression of Interest has been tabled with the Framework 6 Programme for networking within radiochemistry in Europe. The WP will liaise with the International Isotope Society and the International Society on Radiopharmaceutical Chemistry and Biology to seek to communicate and to consider ways of working together.

Realizing a desired family size: when should couples start?

Science.gov (United States)

Habbema, J Dik F; Eijkemans, Marinus J C; Leridon, Henri; te Velde, Egbert R

2015-09-01

plausible changes in model assumptions. Our conclusions would have been more persuasive if derived directly from large-scale prospective studies. An evidence-based simulation study (as we did) is the next best option. We recommend that the simulations should be updated every 5-10 years with new evidence because, owing to improvements in IVF technology, the assumptions on IVF success chances in particular run the risk of becoming outdated. Information on the chance of family completion at different starting ages is important for prospective parents in planning their family, for preconception counselling, for inclusion in educational courses in human biology, and for increasing public awareness on human reproductive possibilities and limitations. No external funding was either sought or obtained for this study. There are no conflicts of interest to be declared. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.

FDMA-PON architecture according to the FABULOUS European project

Science.gov (United States)

Abrate, Silvio; Gaudino, Roberto; Charbonnier, Benoit

2013-01-01

In this paper we wish to introduce the FABULOUS European Project, started on the 1st of October 2012, that proposes a new FDMA-PON architecture adopting Faraday rotation and a R-ONU based on a reflective modulator instead of the conventional reflective SOA, designed on purpose and to be realized in silicon photonics, in order to cope with the target performances set by FSAN and the need of realizing low cost devices for the final user.

European Funds – Instrument for Economic Stability/Growth

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Anca Simina POPESCU

2014-11-01

Full Text Available The enlargement of European Union has finally brought a growth of public resources designed for regional policy, but also visible disparities between the member states. The objective of a stronger social and economic cohesion, of reduction of differences of social and economic development between the member states and EU regions, as well as the promotion of sustainable development of EU are reached through structural funds, the European financing being designed to serve as lever regarding public investments in associated countries. This work analyses the elements which assure economic stability in Romania, in the last year of programming period 2007-2013, following the crisis which disturbed global economy. The emphasis is laid on non-refundable EU funds allotted for Romania, which were analyzed both from the point of view of approved projects (but whose implementation did not start yet and regarding the contracted projects under way.

A guided self-help intervention targeting psychological distress among head and neck cancer and lung cancer patients: motivation to start, experiences and perceived outcomes.

Science.gov (United States)

Krebber, Anne-Marie H; van Uden-Kraan, Cornelia F; Melissant, Heleen C; Cuijpers, Pim; van Straten, Annemieke; Becker-Commissaris, Annemarie; Leemans, C René; Verdonck-de Leeuw, Irma M

2017-01-01

Recent results of a randomized clinical trial showed that a guided self-help intervention (based on problem-solving therapy) targeting psychological distress among head and neck cancer and lung cancer patients is effective. This study qualitatively explored motivation to start, experiences with and perceived outcomes of this intervention. Data were collected from semi-structured interviews of 16 patients. All interviews were audio-recorded and transcribed verbatim. Data were analyzed individually by two coders and coded into key issues and themes. Patients participated in the intervention for intrinsic (e.g. to help oneself) and for extrinsic reasons (e.g. being asked by a care professional or to help improve health care). Participants indicated positive and negative experiences with the intervention. Several participants appreciated participating as being a pleasant way to work on oneself, while others described participating as too confrontational. Some expressed their disappointment as they felt the intervention had brought them nothing or indicated that they felt worse temporarily, but most participants perceived positive outcomes of the intervention (e.g. feeling less distressed and having learned what matters in life). Cancer patients have various reasons to start a guided self-help intervention. Participants appreciated the guided self-help as intervention to address psychological distress, but there were also concerns. Most participants reported the intervention to be beneficial. The results suggest the need to identify patients who might benefit most from guided self-help targeting psychological distress and that interventions should be further tailored to individual cancer patients' requirements.

Emergency Department Length of Stay for Maori and European Patients in New Zealand

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David Prisk

2016-06-01

Full Text Available Introduction: Emergency department length of stay (ED LOS is currently used in Australasia as a quality measure. In our ED, Maori, the indigenous people of New Zealand, have a shorter ED LOS than European patients. This is despite Maori having poorer health outcomes overall. This study sought to determine drivers of LOS in our provincial New Zealand ED, particularly looking at ethnicity as a determining factor. Methods: This was a retrospective cohort study that reviewed 80,714 electronic medical records of ED patients from December 1, 2012, to December 1, 2014. Univariate and multivariate analyses were carried out on raw data, and we used a complex regression analysis to develop a predictive model of ED LOS. Potential covariates were patient factors, temporal factors, clinical factors, and workload variables (volume and acuity of patients three hours prior to and two hours after presentation by a baseline patient. The analysis was performed using R studio 0.99.467. Results: Ethnicity dropped out in the stepwise regression procedure; after adjusting for other factors, a specific ethnicity effect was not informative. Maori were, on average, younger, less likely to receive bloodwork and radiographs, less likely to go to our observation area, less likely to have a general practitioner, and more likely to be discharged and to self-discharge; all of these factors decreased their length of stay. Conclusion: Length of stay in our ED does not seem to be related to ethnicity alone. Patient factors had only a small impact on ED LOS, while clinical factors, temporal factors, and workload variables had much greater influence. [West J Emerg Med. 2017;17(4438-448.

Evaluation of the predictive capacity of DNA variants associated with straight hair in Europeans

DEFF Research Database (Denmark)

Pośpiech, Ewelina; Karłowska-Pik, Joanna; Marcińska, Magdalena

2015-01-01

pattern baldness revealed a suggestive association with hair morphology for rs4679955 on 3q25.1. The study results reported provide the starting point for the development of a predictive test for hair morphology in Europeans. More studies are now needed to discover additional determinants of hair...

A new start for European nuclear energy: the forum and the sustainable nuclear energy platform

Energy Technology Data Exchange (ETDEWEB)

Gueldner, Ralf [E.ON Kernkraft GmbH, Hanover (Germany)

2009-06-15

In the next years we will face significant switch stands regarding the future energy mix in Europe. In general, European energy policy has to address three energy challenges for a competitive electricity production (1): - Security of supply; - Limitation of greenhouse gas emissions; and - Providing affordable energy to consumers. Regarding climate precaution the goal of a low carbon economy is very ambitious. The NPP in operation already today contribute to all three goals. Nuclear energy generates two thirds of the EU' low carbon electricity, is one of the most economic energy sources and is less vulnerable to fuel price changes, thereby protecting EU economies against the price volatility of raw materials (2). The investment decisions, which have to been taken in the next 5 to 10 years, will determine the electricity production portfolio in the European Union for the next 50 years: 1. Around 800-900 GWe capacity will be required by 2030 to replace the existing capacity and to address increasing demand. 2. More than 50 % of the electricity in 2030 will be generated in plants have not been build today. 3. A total of 57.6 GWe of new nuclear power plants are projected to be commissioned between 2000 and 2030 (3). Only 9.4 GW of these are already certain investments. To ensure sustainable investment decisions, there needs to be reliable and effective framework conditions with the underlying principles: - competition among vendors; - efficient licensing; - solvent capital markets; - political framework; and - public acceptance. With regard to public acceptance, the Commission launched, based on the results of the EU summit in 2007, a platform for a broad stakeholder discussion about risks, challenges and opportunities of nuclear energy, the European Nuclear Energy Forum (ENEF). E.ON is actively involved in both discussion during the annual ENEF-summit and the working group sessions throughout the year. We appreciate these discussion and we face up the pros and

STARTing Again: What Happens After START I Expires?

International Nuclear Information System (INIS)

Mladineo, Stephen V.; Durbin, Karyn R.; Eastman, Christina M.

2007-01-01

The Strategic Arms Reduction Treaty (START I), a seminal arms control agreement that substantially reduced the levels of deployed strategic nuclear arms in the United States and Russia, will expire in December 2009. At this time, it is unclear what - if anything - will replace it. While the treaty remains relevant, more than a simple extension is appropriate. Instead the authors advocate for a successor regime that builds on the START I legacy but does not rely on the traditional tools of arms control. This paper examines the strategic context in which a successor regime would be developed and proposes several recommendations for future action

Judicial aspects of emission trade. Emission trade in the European Union

International Nuclear Information System (INIS)

Van Beuge, M.J.J.

2004-01-01

Emission trade will start in Europe in 2005. In a series of articles an overview will be given of several juridical aspects with respect to the international and national trade of emission. In part 1 attention was paid to the international judicial basis for the present climate policy. In this article an overview is given of developments with regard to emission trade in the European Union [nl

Extent and application of patient diaries in Austria

DEFF Research Database (Denmark)

Heindl, Patrik; Bachlechner, Adelbert; Nydahl, Peter

2017-01-01

Background: Diaries written for patients in the intensive care unit (ICU) are offered in many European countries. In Austria, ICU diaries have been relatively unknown, but since 2012, they have started to emerge. Aim: The aim of this study was to explore the extent and application of ICU diaries...... in Austria in 2015. Method: The study had a prospective multiple methods design of survey and interviews. All ICUs in Austria were surveyed in 2015 to identify which ICUs used diaries. ICUs using diaries were selected for semi-structured key-informant telephone interviews on the application of ICU diaries...

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

Science.gov (United States)

Dinis-Ribeiro, M.; Areia, M.; de Vries, A. C.; Marcos-Pinto, R.; Monteiro-Soares, M.; O'Connor, A.; Pereira, C.; Pimentel-Nunes, P.; Correia, R.; Ensari, A.; Dumonceau, J. M.; Machado, J. C.; Macedo, G.; Malfertheiner, P.; Matysiak-Budnik, T.; Megraud, F.; Miki, K.; O'Morain, C.; Peek, R. M.; Ponchon, T.; Ristimaki, A.; Rembacken, B.; Carneiro, F.; Kuipers, E. J.

2012-01-01

Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods. PMID:22198778

Does peritoneal dialysis have a role in urgent-start end-stage kidney disease?

Science.gov (United States)

McQuillan, Rory F; Lok, Charmaine E

2018-04-19

Despite its many positive attributes, peritoneal dialysis remains underutilized, particularly in the United States. Urgent-start peritoneal dialysis (PD) has been proposed as a method of increasing PD prevalence. Urgent-start PD has been shown to be safe, feasible, and effective. However, urgent-start PD is also accompanied by several multidimensional challenges. This article is intended to equip the reader with a practical sense of whether an urgent-start PD program would be appropriate in his or her own clinical context and if appropriate, what factors would be necessary for such a program to flourish. As such, we summarize latent factors, which are necessary to consider before instituting an urgent-start PD. Then, using a series of clinical vignettes, highlight the component parts of a successful urgent-start PD program and the patient population who stand to benefit most from this strategy. The discussion is then balanced by presenting limitations to consider in the urgent-start PD approach. © 2018 Wiley Periodicals, Inc.

Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM): EURObservational Research Programme in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on PPCM.

Science.gov (United States)

Sliwa, Karen; Mebazaa, Alexandre; Hilfiker-Kleiner, Denise; Petrie, Mark C; Maggioni, Aldo P; Laroche, Cecile; Regitz-Zagrosek, Vera; Schaufelberger, Maria; Tavazzi, Luigi; van der Meer, Peter; Roos-Hesselink, Jolien W; Seferovic, Petar; van Spandonck-Zwarts, Karin; Mbakwem, Amam; Böhm, Michael; Mouquet, Frederic; Pieske, Burkert; Hall, Roger; Ponikowski, Piotre; Bauersachs, Johann

2017-09-01

The purpose of this study is to describe disease presentation, co-morbidities, diagnosis and initial therapeutic management of patients with peripartum cardiomyopathy (PPCM) living in countries belonging to the European Society of Cardiology (ESC) vs. non-ESC countries. Out of 500 patients with PPCM entered by 31 March 2016, we report on data of the first 411 patients with completed case record forms (from 43 countries) entered into this ongoing registry. There were marked differences in socio-demographic parameters such as Human Development Index, GINI index on inequality, and Health Expenditure in PPCM patients from ESC vs. non-ESC countries (P heart failure after 1 month (92.3% vs. 81.3%, P heart failure were common within 1 month post-diagnosis and required intensive, multidisciplinary management. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

ROMANIAN ADMINISTRATIVE CAPACITY OF EUROPEAN FUNDS ABSOBTION

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Irina Bosie (Ungureanu

2011-12-01

Full Text Available The capacity to absorb European funds is part of a state complex integrated admninistrative capacity, a component of a state as a whole. The analysis in this article starts from the theoretical development by studying the reports made by the Romanian Government, correlated with the European Union reports on funds and Romanian legislation. This analysis of the EU's structural funds, highlights the importance of accessing them and the degree to which Romania and member countries benefits of income support.European funds are meant to supplement a member of the Union funds to the extent that they are accessed through the projects. Money allocated on type of operation is distributed in amounts proportionate to that state needs. Money distributed will be justified by their realization of infrastructure projects, environment, transport, human resources development, rural and regional development.Theoretical research lay the foundation for determining administrative capacity in Romania from the first time of defining the concept until now. Empirical research reveals the degree of absorption of which is that Romania has in comparison with some EU countries, former socialist countries present democratic states.The absorption capacity of European funds determine the strength of a state administrative management issues in the management of monetary dated. Power in handling management administrative problems can be efficient in higher manner and it’s represented by cost-benefit analysis and the degree of satisfaction of citizen interest. As public services are financially supported and developed, the degree of citizen satisfaction is greater in an implemented decentralized administrative system.

Recent migration developments in the European perspective

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Milan Palát

2012-01-01

Full Text Available The aim of the paper is to evaluate the development of international migration in relationship to the recent economic situation in member countries of the European Union using quantitative methods including cluster analysis. The number of immigration in Europe has declined since the start of the global recession. The main reason was the decrease of demand in many sectors of the national economy, for instance the demand for retail and construction workers. Despite the drop in new immigration, labour markets of the EU countries were hit very severely. Unemployment rates in the most of European countries increased much more in the category of migrants than among natives. Despite the general decline in immigration in Europe during the economic crisis, the number of immigrants employed in educational sector and health care has increased. Also the number of female immigrants has been growing. The cluster analysis uses a multidimensional variable that includes GDP, unemployment, inflation rate and also net migration. We can distinguish two main clusters in 2010. The majority of highly developed West European countries are a part of the first cluster; the second cluster includes the group of post-communist countries. The latter countries form two sub-groups. A relatively independent sub-cluster is formed by some of the EU15 countries that were hit by the financial crisis the most. In general, the main two clusters illustrate that the economic division of established and new member countries of the European Union is still present.

PECULIARITIES OF RAISING YOUNG-OF-THE-YEAR EUROPEAN GRAYLING (THYMALLUS THYMALLUS L.

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A. Kucheruk

2015-10-01

Full Text Available Purpose. The study was aimed at raising young-of-the-year European grayling and improving the industrial technology with the use of specialized artificial feeds. Methodology. The work on raising young-of-the-year European grayling was carried out in 2014 at the fish hatchery “Lopushno”, Chernivtsi region, during five months (May – September. YOY were obtained from 22 age-3–4 brood fish, which were kept in ponds of the natural reserve “Synevir”. Culture-biological parameters of brood fish were determined based on Pravdin (1966 method for salmonids. To avoid traumatization of fish, they were kept in the anesthetic “Propiscin” before the collection of sexual products. The condition factor was determined by Fulton’s formula. Findings. The mean weight of brood fish used for spawning was 110 g with the mean body length of 22 cm. Fulton’s condition factor of European grayling was: 1.1 in females and 1.0 in males. Feeding of larvae was as follows: starting feeds — live feeds (Cyclops, Moina, then the alternation of live feeds and a specialized starting feed for 30 days, and the artificial feed after. Raising European grayling from larvae to young-of-the-year was carried out in trays of different sizes from 0.5 m2 to 4.5 m2, water level in trays was increased according to fish growth from 20 cm to 42 cm. Water supply was 60 L/min, thus the rate of water exchange was from 0.5 to 1.7 times/hour that corresponded to technical norms for salmonids. Mean weight of the young-of-the-year on September 10 was 17.1 g, mean length was 11.8 cm. Originality. Consists in the comprehensive assessment and development of an integral mechanism of scientific principles and methodical recommendations on artificial reproduction of European grayling. Practical value. The results of the work will be used for the works on the reproduction of valuable fish species in aquaculture facilities of the Carpathian region.

Therapeutic hypothermia following out-of-hospital cardiac arrest; does it start in the emergency department?

Science.gov (United States)

Galloway, R; Sherren, P B

2010-12-01

The use of therapeutic hypothermia after cardiac arrest is a well-practised treatment modality in the intensive care unit (ICU). However, recent evidence points to advantages in starting the cooling process as soon as possible after the return of spontaneous circulation (ROSC). There are no data on implementation of this treatment in the emergency department. A telephone survey was conducted of the 233 emergency departments in the UK. The most senior available clinician was asked if, in cases where they have a patient with a ROSC after an out-of-hospital cardiac arrest, would therapeutic hypothermia be started in the emergency department. Of the 233 hospitals called, 230 responded, of which 35% would start cooling in the emergency department. Of this 35%, over half (56%) said the decision to start cooling was made by the emergency physician before consultation with the ICU. Also, of the 35% who would begin cooling in the emergency department, 55% would cool only for ventricular fibrillation/ventricular tachycardia, 66% would monitor temperature centrally, and 14% would use specialised cooling equipment. There is often a delay in getting patients to ICU from the emergency department, and thus the decision not to start cooling in the emergency department may impact significantly on patient outcome. The dissemination of these data may persuade emergency physicians that starting treatment in the emergency department is an appropriate and justifiable decision that is becoming a more accepted practice throughout the UK.

Impact of hepatitis B vaccination on acute hepatitis B epidemiology in European Union/European Economic Area countries, 2006 to 2014

Science.gov (United States)

Miglietta, Alessandro; Quinten, Chantal; Lopalco, Pier Luigi; Duffell, Erika

2018-01-01

Hepatitis B prevention in European Union/European Economic Area (EU/EEA) countries relies on vaccination programmes. We describe the epidemiology of acute hepatitis B virus (HBV) at country and EU/EEA level during 2006–2014. Using a multi-level mixed-effects Poisson regression model we assessed differences in the acute HBV infection notification rates between groups of countries that started universal HBV vaccination before/in vs after 1995; implemented or not a catch-up strategy; reached a vaccine coverage ≥ 95% vs  0.05) were found in the acute HBV infection notification rates between groups of countries, while as vaccine coverage increased, such rates decreased (p < 0.01). Countries with universal HBV vaccination before 1995, a catch-up strategy, and a vaccine coverage ≥ 95% had significant decreasing trends (p < 0.01). Ending HBV transmission in Europe by 2030 will require high vaccine coverage delivered through universal programmes, supported, where appropriate, by catch-up vaccination campaigns. PMID:29439751

Tracks for Eastern/Western European Future Launch Vehicles Cooperation

Science.gov (United States)

Eymar, Patrick; Bertschi, Markus

2002-01-01

exclusively upon Western European elements indigenously produced. Yet some private initiatives took place successfully in the second half of the nineties (Eurockot and Starsem) bringing together companies from Western and Eastern Europe. Evolution of these JV's are already envisioned. But these ventures relied mostly on already existing vehicles. broadening the bases in order to enlarge the reachable world market appears attractive, even if structural difficulties are complicating the process. had recently started to analyze, with KSRC counterparts how mixing Russian and Western European based elements would provide potential competitive edges. and RKA in the frame of the new ESA's Future Launch Preparatory Programme (FLPP). main technical which have been considered as the most promising (reusable LOx/Hydrocarbon engine, experimental reentry vehicles or demonstrators and reusable launch vehicle first stage or booster. international approach. 1 patrick.eymar@lanceurs.aeromatra.com 2

Clinical PET activities in European and Asia-Oceanian Countries

International Nuclear Information System (INIS)

Tashiro, Manabu; Ito, Masatoshi; Yamaguchi, Keiichiro; Kubota, Kazuo; Fujimoto, Toshihiko; Sasaki, Hidetada; Moser, E.

2001-01-01

Clinical diagnosis using positron emission tomography (PET) requires high costs. Therefore, sociomedical evaluation is very important for spread of clinical PET. In this report, sociomedical situation in European and Asia-Oceanian countries, especially concerning transportation of 18 F-FDG and reimbursement of medical costs for clinical PET indications, is reported. It seems that UK, Germany and Belgium are the most advanced in clinical PET in Europe. In these countries, many PET investigations are reimbursed though systems are different among the countries. In UK, both public and private insurance gives authorization for clinical PET to some extent. In Germany, private health insurance companies give authorization but public insurance has not. In Belgium, private health insurance does not exist and public insurance gives authorization for clinical PET. Other European countries seem to be in transitional stages. Transportation of 18 F-FDG has been already started in almost every country in Europe and Asia-Oceania. In Japan, neither transportation of FDG nor full reimbursement of clinical PET has not started yet and this situation seems to be exceptional. To promote clinical PET in Japan, there is the need of at least establishing a list of clinical indications for PET investigations and establishing commercial-based 18 F-FDG supplying system. They could be regarded as a kind of infrastructure for spread of clinical PET. (author)

From START to NEW START. The dilemma and future of nuclear disarmament

International Nuclear Information System (INIS)

Plettenberg, Lars

2012-01-01

The report describes the existing four agreements on nuclear disarmament: START I (1991). START II (1993), SORT (2002) and NEW START (2010). The chapter on the dependence between nuclear disarmament and strategic stability covers the issues mutual assured destruction (MAD), credibility, overkill capacity; the role of nuclear weapons in the national strategies of the USA and NATO, Russia, Great Britain, France, China and the other nuclear states. Ways out of MAD include disarmament, de-alerting and mutual assured protection (MAP).

Small area detectors at the European XFEL

Science.gov (United States)

Turcato, M.; Gessler, P.; Hauf, S.; Kuster, M.; Meyer, M.; Nordgren, J.; Sztuk-Dambietz, J.; Youngman, C.

2014-05-01

The detectors to be used at the European XFEL have to deal with the unique time structure of the machine, delivering up to 2700 pulses, with a repetition rate of 4.5 MHz, ten times per second, the very high photon flux and the need to combine single-photon sensitivity and a large dynamic range. This represents a challenge not only for the large-area 2D imaging detectors but also for the smaller-area detectors and makes the use of standard commercial devices impossible. Dedicated solutions are therefore envisaged for small imaging- or strip-detectors. In this contribution the focus is put on two particular small-area detector solutions which are planned to be used at the European XFEL, a strip detector for hard X-rays (with energy 3 < E < 25 keV) and an imaging detector for soft X-rays (0.25 < E < 3 keV). Hard X-rays photon-beam diagnostics as well as hard X-ray absorption and emission spectroscopy at the European XFEL make use of strip detectors as detectors for beam spectrometers or as energy-dispersive detectors in combination with an energy-dispersive element. The European XFEL is establishing cooperation with the Paul Scherrer Institute in Villigen to develop a new version of the Gotthard detector best suited to the European XFEL needs. The use case and the required detector specifications are illustrated. Starting from the present detector version, the modifications planned to adapt it to the European XFEL running conditions are described. These include the capability of running at an increased rate and to provide a veto signal to the large 2D imaging detectors, in order to be able to remove non-interesting images already at early stages of the DAQ system. In another particular application, resonant inelastic X-ray scattering, a Micro-Channel Plate detector matched to a delay-line readout is foreseen to be used. In this case the European XFEL is aiming for a highly customized solution provided by the German company Surface Concept. The use case is described

The Consolidation on Banking Supervision in the Context of a Pan European Banking System

Directory of Open Access Journals (Sweden)

Teodora Barbu

2007-03-01

Full Text Available The diversity of national banking systems in the European banking system and the absence of consolidated supervision creates the premises for a series of interrogations whose essence is the same: Is it possible to discuss about a Pan European Banking System? The starting point in answering this question was the efforts to create a single banking market, which took place in 1973-1999, and the impact of integration on the European Banking Industry. Among the most representative aspects, it must be emphasized the necessity of consolidating banking supervision at an European level, considering that the International Banking Community studies the problematic of banking regulations at a global level. The two dimensions of the prudential and European bank supervision device – the geographic and the institutional – demand the creation of a structural reform in order to ensure the functioning of a Pan European system of banking supervision and regulations. The considerations on the Consolidation of European Banking Supervision draws into discussion the Financial Supervision Authority which has generalized as an applicable model in numerous European countries and has been mentioned as an alternative of Pan European banking supervision. In the process of the integration of the banking sector, the Basel II Accord represents an opportunity in reaching a convergence of national regulations and practices in matters of risk management, considering that these actions are in line with the preoccupations of realizing a Pan European banking system. Thus, the creation of Pan European banking system involves actions in more directions: legal, institutional, operational meant to ensure the consolidation of banking supervision.

The impact of dry-land sprint start training on the short track speed skating start.

Science.gov (United States)

Haug, William B; Drinkwater, Eric J; Cicero, Nicholas J; Barthell, J Anthony; Chapman, Dale W

2017-05-05

This investigation sought to determine the effects of dry-land sprint start training on short track speed skating (STSS) start performance. Nine highly trained short track athletes completed a control period of normal STSS training followed by a four-week training intervention. Before and after the control and intervention periods, athletes performed three electronically timed dry-land and on-ice 14.43 m maximal sprint start efforts. The intervention consisted of two sprint sessions per week consisting of nine electronically timed 14.43 m dry-land sprint starts in addition to normal STSS training. The control period resulted in no substantial change in on-ice start performance (Mean Δ: -0.01 s, 95% Confidence Limits (CL): -0.08 to 0.05 s; Effect Size (ES): -0.05; Trivial) however, a small change was observed in dry-land start performance (Mean Δ: -0.07 s, 95% CL: -0.13 to -0.02 s; ES: -0.49). Following brief specific dry-land sprint start training a small improvement was observed in both on-ice (Mean Δ: -0.07 s, 95% CL: -0.13 to -0.01 s; ES: -0.33) and dry-land (Mean Δ: -0.04 s, 95% CL: -0.09 to 0.00 s; ES: -0.29) start performance. This investigation suggests STSS start performance can be improved through a brief dry-land sprint start training program.

Hospital care for persons with AIDS in the European Union

NARCIS (Netherlands)

Postma, Maarten; Tolley, K; Leidl, R M; Downs, A M; Beck, E J; Tramarin, A M; Flori, Y A; Santin, M; Antoñanzas, F; Kornarou, H; Paparizos, V C; Dijkgraaf, M G; Borleffs, J; Luijben, A J; Jager, J C

This study estimates the current and future hospital resources for AIDS patients in the European Union (EU), using multinational scenario analysis (EU Concerted Action BMH1-CT-941723). In collaboration with another EU-project ('Managing the Costs of HIV Infection'), six national European studies on

Results of a consensus meeting on the use of argatroban in patients with heparin-induced thrombocytopenia requiring antithrombotic therapy - a European Perspective

DEFF Research Database (Denmark)

Alatri, Adriano; Armstrong, Anna-Elina; Greinacher, Andreas

2012-01-01

Argatroban has been introduced as an alternative parenteral anticoagulant for HIT-patients in several European countries in 2005. In 2009 a panel of experts discussed their clinical experience with argatroban balancing risks and benefits of argatroban treatment in managing the highly procoagulant...

The European Urology Residents Education Programme Hands-on Training Format: 4 Years of Hands-on Training Improvements from the European School of Urology.

Science.gov (United States)

Somani, Bhaskar K; Van Cleynenbreugel, Ben; Gozen, Ali; Palou, Jaun; Barmoshe, Sas; Biyani, Shekhar; Gaya, Josep M; Hellawell, Giles; Pini, Gio; Oscar, Faba R; Sanchez Salas, Rafael; Macek, Petr; Skolarikos, Andreas; Wagner, Christian; Eret, Viktor; Haensel, Stephen; Siena, Giampaolo; Schmidt, Marek; Klitsch, Max; Vesely, Stepan; Ploumidis, Achilles; Proietti, Silvia; Kamphuis, Guido; Tokas, Theodore; Geraghty, Rob; Veneziano, Dominico

2018-03-14

The European School of Urology (ESU) started the European Urology Residents Education Programme (EUREP) in 2003 for final year urology residents, with hands-on training (HOT) added later in 2007. To assess the geographical reach of EUREP, trainee demographics, and individual quality feedback in relation to annual methodology improvements in HOT. From September 2014 to October 2017 (four EUREP courses) several new features have been applied to the HOT format of the EUREP course: 1:1 training sessions (2015), fixed 60-min time slots (2016), and standardised teaching methodology (2017). The resulting EUREP HOT format was verified by collecting and prospectively analysing the following data: total number of participants attending different HOT courses; participants' age; country of origin; and feedback obtained annually. A total of 796 participants from 54 countries participated in 1450 HOT sessions over the last 4 yr. This included 294 (20%) ureteroscopy (URS) sessions, 237 (16.5%) transurethral resection (TUR) sessions, 840 (58%) basic laparoscopic sessions, and 79 (5.5%) intermediate laparoscopic sessions. While 712 residents (89%) were from Europe, 84 (11%) were from non-European nations. Of the European residents, most came from Italy (16%), Germany (15%), Spain (15%), and Romania (8%). Feedback for the basic laparoscopic session showed a constant improvement in scores over the last 4 yr, with the highest scores achieved last year. This included feedback on improvements in tutor rating (p=0.017), organisation (ptraining curriculum with wet laboratory or cadaveric courses in this format, although these could be performed in other training centres in conjunction with EUREP. The EUREP trainee demographics show that the purpose of the course is being achieved, with excellent feedback reported. While European trainees dominate the demographics, participation from a number of non-European countries suggests continued ESU collaboration with other national societies and

The European populist challenge

Directory of Open Access Journals (Sweden)

Yannis Stavrakakis

2013-01-01

Full Text Available In today’s Europe, the word ‘populism’ usually refers to right-wing populism or the populist extreme right. Is, however, the concept of ‘populism’ the proper theoreticopolitical instrument through which such identifications should be perceived, categorized and debated? What are the implications (direct and indirect of such a naming? And what are the risks for critical analysis and for democratic politics in the European context? The hypothesis explored in this essay is that sticking to a restrictive association between ‘populism’ and the extreme right poses certain dangers that have to be seriously taken into account, especially in times of crisis. For a start, it is often premised on a rather simplistic euro-centrism that reduces the broad conceptual spectrum covered by the category ‘populism’ in its global use to a very particular European experience and then essentializes the resulting association, over-extending its scope. In addition, the category ‘populism’ is aften used to describe political forces, identities and discourses in which the role of ‘the people’ is only secondary or peripheral, to the extent that it has to coincide with strongly hierarchical and elitist visions of society. What complicates things even further is that, within the context of the European (economic and political crisis, whoever questions/ resists the austerity agenda – especially on the left – is increasingly discredited and denounced as an irresponsible populist. Indeed, it is not by coincidence that doubts are increasingly voiced both in the theoretical and in the political literature regarding the rationale behind such a strong association between populism and the extreme right. A series of points will thus be raised that may help us develop a plausible theoretico-political strategy in the new emerging conditions from a discursive perspective.*

Factors contributing to delay in diagnosis and start of treatment of leprosy

DEFF Research Database (Denmark)

Nicholls, P.G.; Chhina, N; Aaen, Karen Bro

2005-01-01

The objective of our research was to identify factors contributing to delay in diagnosis and start of treatment in leprosy, focussing on patients' narratives of help-seeking behaviour. Our research took place in Purulia, West Bengal, India and in Nilphamari, northern Bangladesh. Between January...... and August 2000, we conducted semi-structured interviews with 104 patients that explored each individual's narrative of help-seeking behaviour and the context of beliefs and attitudes towards leprosy. Subsequently we surveyed 356 patients currently receiving treatment for leprosy and recorded specific...... aspects of each help-seeking action and their reports of local beliefs and attitudes towards leprosy. Delay was estimated from time of first symptoms through to start of effective treatment (mean 18 months, median 9 months in Purulia and mean 20 months, median 12 months in Nilphamari). The number of help...

Start-up and incremental practice expenses for behavior change interventions in primary care.

Science.gov (United States)

Dodoo, Martey S; Krist, Alex H; Cifuentes, Maribel; Green, Larry A

2008-11-01

If behavior-change services are to be offered routinely in primary care practices, providers must be appropriately compensated. Estimating what is spent by practices in providing such services is a critical component of establishing appropriate payment and was the objective of this study. In-practice expenditure data were collected for ten different interventions, using a standardized instrument in 29 practices nested in ten practice-based research networks across the U.S. during 2006-2007. The data were analyzed using standard templates to create credible estimates of the expenses incurred for both the start-up period and the implementation phase of the interventions. Average monthly start-up expenses were $1860 per practice (SE=$455). Most start-up expenditures were for staff training. Average monthly incremental costs were $58 ($15 for provision of direct care [SE=$5]; $43 in overhead [SE=$17]) per patient participant. The bulk of the intervention expenditures was spent on the recruitment and screening of patient participants. Primary care practices must spend money to address their patients' unhealthy behaviors--at least $1860 to initiate systematic approaches and $58 monthly per participating patient to implement the approaches routinely. Until primary care payment systems incorporate these expenses, it is unlikely that these services will be readily available.

Burn patient care lost in good manufacturing practices?

Science.gov (United States)

Dimitropoulos, G.; Jafari, P.; de Buys Roessingh, A.; Hirt-Burri, N.; Raffoul, W.; Applegate, L.A.

2016-01-01

Summary Application of cell therapies in burn care started in the early 80s in specialized hospital centers world-wide. Since 2007, cell therapies have been considered as “Advanced Therapy Medicinal Products” (ATMP), so classified by European Directives along with associated Regulations by the European Parliament. Consequently, regulatory changes have transformed the standard linear clinical care pathway into a more complex one. It is important to ensure the safety of cellular therapies used for burn patients and to standardize as much as possible the cell sources and products developed using cell culture procedures. However, we can definitely affirm that concentrating the bulk of energy and resources on the implementation of Good Manufacturing Practice (GMP) alone will have a major negative impact on the care of severely burned patients world-wide. Developing fully accredited infrastructures and training personnel (required by the new directives), along with obtaining approval for clinical trials to go ahead, can be a lengthy process.We discuss whether or not these patients could benefit from cell therapies provided by standard in-hospital laboratories, thus avoiding having to meet rigid regulations concerning the use of industrial pharmaceutical products. “Hospital Exemption” could be a preferred means to offer burn patients a customized and safe product, as many adaptations may be required throughout their treatment pathway. Patients who are in need of rapid treatment will be the ones to suffer the most from regulations intended to help them. PMID:28149232

The European Synchrotron Radiation Facility - an overview of planned diffraction capability

International Nuclear Information System (INIS)

Kvick, A.

1991-01-01

The European Synchrotron Radiation Facility (ESRF) is a third generation synchrotron radiation facility presently being built as a joint venture between 12 European countries in Grenoble, France. The ESRF will be a low emittance 6 GeV storage ring aimed at producing high-brilliance synchrotron radiation from 29 insertion devices and from 27 bending magnet ports. The general user program will start in the middle of 1994 with seven ESRF beam-lines. By 1999, 30 facility beam-lines as well as beam-lines built and financed by Collaborating Research Groups are scheduled to be in operation. The guidelines for the first beam-lines to be constructed as well as a survey of the diffraction oriented beam-lines built by the ESRF are given in the article. (author)

Danish Ophthalmology - from start to 1865.

Science.gov (United States)

Norn, Mogens

2016-03-01

This short paper mentioned the medical treatment using the 'holy' springs, the first 'eye doctor' in Denmark, the first picture of spectacles which was found in Viborg Cathedral of the high priest before he performs circumcisio praeputii on Jesus Christ, further cataract reclination in Denmark from around year zero and cataract extraction in 1667 in Denmark on a goose by Francisco Borri and on humans by the Danish Georg Heuermann in 1755. Epidemic military eye diseases in 1807, 1856 and 1865 are also described in this study. From 1856, a new ophthalmological period started in Denmark with the first eye hospital (lazaret only for eye diseases), and in 1864, patients with eye diseases were transported from the few beds in the surgical departments in the municipal hospital to the first civil eye department in Denmark, the eye hospital Sct. Annae in Copenhagen. The new scientific period started with Jacob Christian Bentz (ophthalmia granulosa, joint editor of the Danish Medical Journal) and Heinrich Lehmann. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

INNOVATION IN THE EUROPEAN UNION

Directory of Open Access Journals (Sweden)

VLADIMIR-CODRIN IONESCU

2014-11-01

Full Text Available In the contemporary knowledge-based society, innovation, as a vector used for the application and promotion of inventions and innovations, is one of the main sources used for obtaining a sustainable competitive advantage. The present paper points out the main directions which the European Commission aims to develop in the sphere of innovation, within the context of the Initiative: “A Union of Innovation”, which is part of the Europe 2020 Strategy. The paper analyses the performances accomplished by the EU states in the area of innovation while developing an international perspective that may represent the starting point in identifying solutions whereby the EU could reduce the gaps that exist in relation to the main international competitors, i.e. South Korea, USA and Japan.

INNOVATION IN THE EUROPEAN UNION

Directory of Open Access Journals (Sweden)

Vladimir-Codrin IONESCU

2014-05-01

Full Text Available In the contemporary knowledge-based society, innovation, as a vector used for the application and promotion of inventions and innovations, is one of the main sources used for obtaining a sustainable competitive advantage. The present paper points out the main directions which the European Commission aims to develop in the sphere of innovation, within the context of the Initiative: “A Union of Innovation”, which is part of the Europe 2020 Strategy. The paper analyses the performances accomplished by the EU states in the area of innovation while developing an international perspective that may represent the starting point in identifying solutions whereby the EU could reduce the gaps that exist in relation to the main international competitors, i.e. South Korea, USA and Japan.

ECONOMIC CRISIS AND ECONOMIC DISPARITIES IN EUROPEAN UNION

Directory of Open Access Journals (Sweden)

Rodica CRUDU

2015-09-01

Full Text Available The impact of the economic and financial crisis is still being felt. It started as an acute crisis of the banking system, but then quickly affected the real economy, causing a substantial slump in business investment, household demand and output. The current economic crisis has affected almost all European countries but the countries of the European south and the former eastern socialist republics have suffered the most. The objective in this paper is to quantify economic disparities as expressed by several growth indicators, such as GDP per capita, employment/unemployment rates, labour productivity rates and use them to compare the economic performances before and after the crisis. EU took several measures to recover from the economic crisis. Nevertheless, its ability to adjust to widely diverse national and local contexts that have been impacted differently by the effects of the crisis, and to support the different patterns of economic growth that will result from it, is yet to be seen.

Time trends of period prevalence rates of patients with inhaled long-acting beta-2-agonists-containing prescriptions: a European comparative database study.

Directory of Open Access Journals (Sweden)

Marietta Rottenkolber

Full Text Available Inhaled, long-acting beta-2-adrenoceptor agonists (LABA have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology.A common study protocol was applied to seven European healthcare record databases (Denmark, Germany, Spain, the Netherlands (2, and the UK (2 to calculate crude and age- and sex-standardised annual period prevalence rates (PPRs of LABA-containing prescriptions from 2002-2009. Annual PPRs were stratified by sex, age, and indication (asthma, COPD, asthma and COPD.From 2002-2009, age- and sex-standardised PPRs of patients with LABA-containing medications increased in all databases (58.2%-185.1%. Highest PPRs were found in men ≥ 80 years old and women 70-79 years old. Regarding the three indications, the highest age- and sex-standardised PPRs in all databases were found in patients with "asthma and COPD" but with large inter-country variation. In those with asthma or COPD, lower PPRs and smaller inter-country variations were found. For all three indications, PPRs for LABA-containing prescriptions increased with age.Using a standardised protocol that allowed direct inter-country comparisons, we found highest rates of LABA-containing prescriptions in elderly patients and distinct differences in the increased utilisation of LABA-containing prescriptions within the study period throughout the five European countries.

The EMBARC European Bronchiectasis Registry: protocol for an international observational study

Directory of Open Access Journals (Sweden)

James D. Chalmers

2016-01-01

Full Text Available Bronchiectasis is one of the most neglected diseases in respiratory medicine. There are no approved therapies and few large-scale, representative epidemiological studies. The EMBARC (European Multicentre Bronchiectasis Audit and Research Collaboration registry is a prospective, pan-European observational study of patients with bronchiectasis. The inclusion criterion is a primary clinical diagnosis of bronchiectasis consisting of: 1 a clinical history consistent with bronchiectasis; and 2 computed tomography demonstrating bronchiectasis. Core exclusion criteria are: 1 bronchiectasis due to known cystic fibrosis; 2 age <18 years; and 3 patients who are unable or unwilling to provide informed consent. The study aims to enrol 1000 patients by April 2016 across at least 20 European countries, and 10 000 patients by March 2020. Patients will undergo a comprehensive baseline assessment and will be followed up annually for up to 5 years with the goal of providing high-quality longitudinal data on outcomes, treatment patterns and quality of life. Data from the registry will be available in the form of annual reports. and will be disseminated in conference presentations and peer-reviewed publications. The European Bronchiectasis Registry aims to make a major contribution to understanding the natural history of the disease, as well as guiding evidence-based decision making and facilitating large randomised controlled trials.

Monitoring the European standard series in 10 centres 1996-2000

DEFF Research Database (Denmark)

Bruynzeel, D P; Diepgen, T L; Andersen, Klaus Ejner

2005-01-01

A 5-year retrospective study of the frequency of sensitization to the 25 allergens of the European standard series (ESS) was conducted in 10 centres in 8 European countries. Included were the results of 26 210 patients. The range in sensitivities differed moderately between the centres. Combining...

The Rome II Regulation on the Law Applicable to Non-Contractual Obligations: The European Private International Law Tradition Continued. : Introductory Observations, Scope, System, and General Rules

NARCIS (Netherlands)

X.E. Kramer (Xandra)

2008-01-01

textabstractThe establishment of Regulation No 864/2007 on the Law Applicable to Non-Contractual Obligations (Rome II) is a landmark for European Private International Law. The regulation of torts in the European Union has a history of forty years, starting with the preparation of the Rome

Temporal progression in migratory status and sexual maturation in European silver eels during downstream migration

NARCIS (Netherlands)

Palstra, A.P.; Guerrero, M.A.; Klein Breteler, J.G.P.; Thillart, G.E.E.J.M.

2011-01-01

The onset of downstream migration of European eels is accompanied by a cessation of feeding and the start of sexual maturation which stresses the link between metabolism and sexual maturation, also suggesting an important role for exercise. Exercise has been tested with eels in swim tunnels and was

School Starting Age and Crime

DEFF Research Database (Denmark)

Landersø, Rasmus; Nielsen, Helena Skyt; Simonsen, Marianne

This paper investigates the effects of school starting age on crime while relying on variation in school starting age induced by administrative rules; we exploit that Danish children typically start first grade in the calendar year they turn seven, which gives rise to a discontinuity in children......’s school starting age. Analyses are carried out using register-based Danish data. We find that higher age at school start lowers the propensity to commit crime, but that this reduction is caused by incapacitation while human capital accumulation is unaffected. Importantly, we also find that the individuals...

Trends in approval times for genetically engineered crops in the United States and the European Unio

NARCIS (Netherlands)

Smart, Richard D.; Blum, Matthias; Wesseler, J.H.H.

2017-01-01

Genetically engineered (GE) crops are subject to regulatory oversight to Ensure their safety for humans and the environment. Their approval in the European Union (EU) starts with an application in a given Member State followed by a scientific risk assessment, and ends with a political

The European Social Survey and European research policy

DEFF Research Database (Denmark)

Kropp, Kristoffer

2017-01-01

This article analyses the history of the European Social Survey (ESS) and its relationship to changes in European research policy, using Bourdieu’s field-analytical approach. It argues that the success of the ESS relied on three interwoven processes that we can understand theoretically in terms...... of the establishment of homological structures and the formation of conjunctural alliances between the field of European social-scientific research and the field of European policy. The three interwoven processes that I depict are: first, the production of a European field of social research, connected to both...... European and national scientific institutions; second, the establishment of European Union (EU) institutions and organisations that were able to identify and link up with social researchers; and third, the formation of conjunctural alliances between the two fields (social science and EU research policy...

Quantifying the prevalence of fuel poverty across the European Union

International Nuclear Information System (INIS)

Thomson, Harriet; Snell, Carolyn

2013-01-01

The literature and policy base for fuel poverty in the UK and Ireland is well established, and there is a growing body of single country studies beyond these two EU member states (for example Brunner et al. (2012), Dubois (2012), and Tirado Herrero and Ürge-Vorsatz (2010)), however, on a European level, the last analysis of fuel poverty was conducted in 2004, prior to the enlargement of the EU. Using survey data this paper presents an updated overview of the prevalence of European fuel poverty in the context of the accession of numerous former social states, and rising fuel prices. Analysis reveals the phenomenon of fuel poverty is occurring across the EU, with particularly high levels of fuel poverty found in Eastern and Southern European states. It is argued that there are both EU and national policy frameworks in place that address climate change and these could be used as a starting point for countries to address fuel poverty through improved domestic energy efficiency measures. This paper reflects research undertaken in 2011, supported by eaga Charitable Trust, within the umbrella of work examining issues of poverty and social exclusion across the EU, which has enabled access to the EU-SILC dataset. - Highlights: ► This research is the first comparative analysis of European fuel poverty since 2004. ► Fuel poverty is a particular problem for eastern and southern European member states. ► Recommendations include the improved integration with current EU climate policies.

Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care - A multicentre study in seven European countries

NARCIS (Netherlands)

Bernsten, C; Bjorkman, [No Value; Caramona, M; Crealey, G; Frokjaer, B; Grundberger, E; Gustafsson, T; Henman, M; Herborg, H; Hughes, C; McElnay, J; Magner, M; van Mil, F; Schaeffer, M; Silva, S; Sondergaard, B; Sturgess, [No Value; Tromp, D; Vivero, L; Winterstein, A

2001-01-01

Objective: This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients: (greater than or equal to 65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries. Design and setting:

How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey.

Science.gov (United States)

Potpara, Tatjana S; Pison, Laurent; Larsen, Torben B; Estner, Heidi; Madrid, Antonio; Blomström-Lundqvist, Carina

2015-03-01

This European Heart Rhythm (EHRA) Scientific Initiatives Committee EP Wire Survey aimed at exploring the common practices in approaching patients with atrial fibrillation (AF) and informing them about their risk profiles and available therapies in Europe. In the majority of 53 responding centres, patients were seen by cardiologists (86.8%) or arrhythmologists (64.2%). First- and follow-up visits most commonly lasted 21-30 and 11-20 min (41.5 and 69.8% of centres, respectively). In most centres (80.2%) stroke and bleeding risk had the highest priority for discussion with AF patients; 50.9% of centres had a structured patient education programme for stroke prevention. Individual patient stroke risk was assessed at every visit in 69.2% of the centres; 46.1% of centres had a hospital-based anticoagulation clinic. Information about non-vitamin K oral anticoagulants (NOACs) was communicated to all AF patients eligible for oral anticoagulation (38.5% of centres) or to warfarin-naive/unstable patients (42.3%). Only two centres (3.8%) had a structured NOAC adherence follow-up programme; in eight centres (15.4%) patients were requested to sign the statement they have been informed about the risks of non-adherence to NOAC therapy, and three centres (5.8%) had a patient education programme. Patient preferences were of the highest relevance regarding oral anticoagulation and AF ablation (64.7 and 49.0% of centres, respectively). This EP Wire Survey shows that in Europe considerable amount of time and resources are used in daily clinical practice to inform AF patients about their risk profile and available therapies. However, a diversity of strategies used across the European hospitals was noted, and further research is needed to better define optimal strategies for informing AF patients about their risk profile and treatment options. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.