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This paper aims to identify and address gaps in cancer treatment and diagnosis within European health services, focusing specifically on discrepancies between clinical guidelines and policy guidelines. It seeks to highlight how the underutilization of advanced diagnostic techniques recommended by medical societies contributes to missed opportunities for improving patient outcomes.A comprehensive analysis was conducted across multiple European countries to assess the compliance and integration of clinical guidelines with the availability of advanced diagnostic technologies. Secondary data related to clinical and policy guidelines in cancer care were collected and analyzed. Key indicators of adoption and utilization of next-generation sequencing and liquid biopsy were examined to evaluate their impact on health service efficiency and patient care.The analysis revealed significant discrepancies between the recommendations of medical societies regarding advanced diagnostic techniques and their adoption in health policy decisions across Europe. Country-specific assessments indicated varying levels of alignment between clinical guidelines and the availability of advanced diagnostics. These findings underscored missed opportunities for optimizing patient care and health service efficiency through better alignment and integration of clinical guidelines with policy decisions.This study concludes that there is a critical need for health policy decision-makers to prioritize the adoption of clinical guidelines in resource allocation and health service organization. Greater attention to the recommendations of medical societies regarding advanced diagnostic techniques could significantly enhance diagnostic accuracy, treatment efficacy, and overall patient outcomes in cancer care. The paper advocates for policy reforms that acknowledge and leverage the potential benefits of advanced diagnostics in improving health service performance and patient-centered care across Europe. [ABSTRACT FROM AUTHOR]

Hydropower currently generates more than all other renewable energies combined. Considering the challenges of climate change and the transition to green energy, it is expected to remain the world's largest source of renewable electricity generation. This paper proposes a tool for performance evaluation and benchmarking of hydropower generation to inform dispatching. Through them, strengths and weaknesses of asset operations can be set, identifying areas with the best performance, gathering insights from their strategies and best practices, and comprehending factors that lead to variations in performance levels. The results allow for optimising energy resource use by indicating the dispatching rules with maximum power production and minimum wear-and-tear impact. This framework allows the formulation of practical guidelines for dispatching policies. The proposed methodology is applied to analyse two real-world case studies: the Vogelgrün run of river hydropower plant (France) and the Frades 2 pump-storage powerplant (Portugal). • Application drives green energy transition by analysing hydropower operation. • Methodology addresses the operational challenges from HPP flexibilities. • The conclusion indicates how to improve power generation and reduce wear and tear. • Real-world case studies establish internal benchmarks for hydropower plants. • Extend the state-of-the-art using the DEA method to guideline dispatch policies. [ABSTRACT FROM AUTHOR]

Few conditions have sparked as much controversy as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Professional consensus has long suggested that the condition should be classified as psychiatric, while patients and advocacy groups have insisted it is a serious biological disease that requires medical care and research to develop it. This longstanding debate shifted in 2015, when U.S. governmental health authorities fully embraced medical classification and management. Given that some globally respected health authorities now insist that ME/CFS is a serious biological disease, this paper asks whether it can be ethical for the U.K. practice guideline now in development to characterize the condition as a mental health disorder. Following a brief history of ME/CFS controversy, I offer three arguments to show that it would be unethical for the U.K. to now characterize ME/CFS as a mental health condition, considering the relevance of that conclusion for ME/CFS guidelines elsewhere and for other contested conditions. [ABSTRACT FROM AUTHOR]

The development of the sustainable energy systems is crucial for economic growth and climate change mitigation. This paper proposes a nonparametric approach based on the by-production technology comprising the economic and environmental sub-technologies. We consider both renewable and fossil energy in the analysis. This approach allows identifying the most relevant energy development strategies at the country level. We examine 42 countries from the OECD, B(R)ICS and ASEAN. The results indicate that most of the countries (23) need to exploit both the energy intensity and carbon factor (energy-mix) effects to ensure sustainable energy development, yet four countries also need to increase the use of the renewable energy in order to secure the economic growth. During 1990–2018, an upward trend for the CO 2 emission shadow price is observed for the selected countries which suggests an improving environmental performance. The results of this study provide further guidelines for adopting effective market-oriented policy measures in the energy sector. • A Data Envelopment Analysis model is constructed to identify performance gaps. • Both energy intensity and energy-mix adjustments are modelled. • Double frontier model is used. • The empirical study covers OECD, B(R)ICS and ASEAN countries. • Most of the countries need to opt for combined energy strategies. [ABSTRACT FROM AUTHOR]

As antiretroviral treatment has led to decreased morbidity, HIV testing policy has increasingly shifted towards routine, provider-initiated approaches. Yet, few studies have examined the acceptability of provider-initiated HIV testing in the intensive, or critical care setting, where knowledge of HIV status is likely to impact on clinical management but explicit consent for testing is difficult to obtain. We conducted qualitative research in an urban hospital and clinic in Johannesburg. In-depth interviews were conducted among HIV testing clients (n= 20), recently discharged critical care patients (n= 13) and family members of critical care patients (n= 14). One focus group discussion was held with health care providers (n= 10). HIV testing in critical care was viewed as acceptable but challenging to implement. An overarching theme of ambivalence emerged from patients and families, who saw HIV testing as a pre-requisite to appropriate clinical care, but were concerned about the quality of its delivery. While providers were aware of the current “no testing without consent” policy, they expressed frustration in cases when testing was in the patient's best interest but consent could not be obtained. Furthermore, providers found it stressful to weigh up patient confidentiality against medical necessity when assessing patients' “best interests”. Without specific guidelines, they often developed pragmatic, ad hoc ways to resolve dilemmas around testing in critical care. Our findings suggest that HIV testing guidelines specific to the critical care setting may help providers do their jobs more ethically and transparently. Provider-initiated approaches are likely to be acceptable to patients and may improve clinical outcomes, but training and support in policy implementation and ethical decision-making are essential. [ABSTRACT FROM AUTHOR]

Abstract: Context: In 2011, the World Health Organization (WHO) published the policy guidelines Ensuring Balance in National Controlled Substances Policies—Guidance for Availability and Accessibility of Controlled Medicines, presenting a revised version of the previous guidelines from 2000. Objectives: To describe the consensus process that guided the revision of the guidelines. Methods: A four-stage revision process was undertaken with a panel of 29 international experts from palliative care, public health, and harm reduction: 1) a qualitative inventory of required changes by means of a structured checklist, 2) & 3) a two-round online consensus Delphi process about the draft revision of the guidelines, and 4) a WHO advisory meeting for the discussion of remaining controversies and final issues. Results: The qualitative inventory resulted in a draft revision of the guidelines meeting requirements on different levels, such as a broader focus and more accurate evidence. Operationalization of the guidelines was improved by specifying measures, procedures, and responsibilities. The Delphi procedure provided concrete indications for the rewording of both the guidelines and the associated text. During the advisory meeting, any persistent disagreements were systematically discussed to achieve consensus on the new version of the guidelines. Conclusion: The four-stage multimethod consensus process resulted in a substantial revision to the WHO guidelines. This takes into account the increase in knowledge about opioid medication since the first edition of the guidelines. Disagreement emerging from the process underlines the complexity of preparing guidance because of the delicate balance between need and control. [Copyright &y& Elsevier]

In emerging economies, the socio-economic status is a key element to evaluate social improvement as it provides an understanding of the population's access to housing, education, health or basic services, such as water and electricity. The relationship between such indicators and human physical mobility has been researched mostly in areas like access to medical infrastructures and public transportation. However, such studies have been limited in scope mostly due to the lack of large-scale human mobility information. Nevertheless, the recent adoption of cell phones by large social groups in emerging economies has made it possible to capture large-scale data about human physical mobility, which combined with regional socio-economic levels (SELs), allows to study the relationship between socio-economic indices and human mobility. In this paper, we study the relationship between mobility variables and SELs using cell phone traces. Our results indicate that populations with higher SELs are strongly linked to larger mobility ranges than populations from lower socio-economic status. Finally, we also present a model that formalizes our findings on the relation between SELs and human mobility. [ABSTRACT FROM AUTHOR]

Abstract: Given the fact of water shortage in the Mediterranean countries, the EMWater project (efficient management of wastewater, its treatment and reuse in the Mediterranean countries) aims to increase the security and safety of water supply through creation of public awareness and implementation of innovative and suitable solutions in wastewater treatment and reuse. The main target countries of this 4-year project are Jordan, Lebanon, Palestine and Turkey. The EMWater project contributes to these goals through training programmes (local, regional and web-based) for technicians, engineers and employees of authorities and non-government organizations; public awareness campaigns; design and construction of pilot plants applying low-cost techniques, as well as through the development of policy guidelines for wastewater treatment and reuse. Such activities will contribute to general objectives of promoting transfer of appropriate wastewater treatment technologies, such as low-cost technologies for rural areas; strengthening local capacities and regional co-operation through the creation of co-operative professional networks; enhancing public awareness of the insufficient and inproper wastewater treatment to the need for hygienically safe disposal, and the potentials of water reuse. The paper is aimed to present the state of implementation of the EMWater project after 3 years, especially focusing on the main steps in pilot plants design and construction activity and in development of guidelines for decision-makers in wastewater management and planning. It further addresses the progress in implementation of capacity building programs. [Copyright &y& Elsevier]