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In a context of stagnation of the level of health-enhancing physical activity in Europe, this study examines the geographical stratification of sports participation and physical activity (PA) at the regional level in 28 European countries. While previous research has focused on the national approach, this study considers the regional level across 208 European regions. Individual survey data from the Eurobarometer 80.2 is combined with a regional-level approach to the 208 regions to quantify sports participation and PA at the regional level. The results show important differences and a geographical stratification of sports participation and PA among the European regions, albeit following different patterns. In particular, a north-south gap is identified in terms of PA rates and an east-west gap is detected in terms of sports participation levels. Applying the cluster technique, a taxonomy of four different European regions is developed considering both types of indicators. Finally, the existence of sports spatial spillovers among regions is verified, obtaining a positive autocorrelation among neighbouring regions for being involved in PA and sporting activities. The results may have significant implications in terms of policy measures to improve health through PA and sports participation at the regional level in Europe. [ABSTRACT FROM AUTHOR]

This study examines the role of regional government quality in health-related participation in sport and physical activity among adults (18–64 years) in 28 European countries. The importance of the analysis rests in the relative autonomy that regional and local governments have over policy decisions connected with sport and physical activity. While existing studies have focussed on economic and infrastructural investment and expenditure, this research investigates the quality of regional governments across 208 regions within 28 European countries. The individual-level data stem from the 2013 Eurobarometer 80.2 (n = 18,675) and were combined with regional-level data from Eurostat. An individual's level of participation in sport and physical activity was measured by three variables reflecting whether an individual's activity level is below, meets, or exceeds the recommendations of the World Health Organization. The results of multi-level analyses reveal that regional government quality has a significant and positive association with individual participation in sport and physical activity at a level meeting or exceeding the guidelines. The impact is much larger than that of regional gross domestic product per capita, indicating that regional disadvantage in terms of political quality is more relevant than being disadvantaged in terms of economic wealth. [ABSTRACT FROM AUTHOR]

Based on the Eurobarometer data from 2009 (N = 26,788), this paper investigates the correlates of sports participation. In addition to examining standard socio-demographic, economic and lifestyle factors, the paper also focuses on the impact of motivational factors, the availability of sports infrastructure and government support, for the first time collectively at the European level. A further contribution of the paper is that it simultaneously investigates both the decision to participate in sport and the frequency of sports participation in this context. This is made possible through the application of a Zero-Inflated Ordered Probit estimator. This estimator also takes into account two types of non-participants: those who have never participated in sport and those who did not participate at the time of the survey. The results show that the decision to participate in sports and the frequency of sports participation of males and females are affected by different factors, therefore distinct government policies should be applied to attract new, and retain the existing, participants. For example, women are affected more by a need to improve self-esteem, while the men to produce social integration. The provision of sports facilities is of more importance for males, which may indicate a male-oriented nature of the sports facilities, for example, the gym. However, the number of adults and the number of children in the household reduce the probability of sports participation by females. Therefore, higher provision of childcare may be important if female participation is to be increased. [ABSTRACT FROM AUTHOR]

One of the main elements common to both the mediaeval anti-Jewish tradition and modern antisemitism is the use of Jewish religious texts-particularly the Talmud-in order to 'prove' that Jews pose a threat to non-Jews. Bravo Lopez considers how a series of anti-talmudic texts written by Sixtus of Siena in the sixteenth century were disseminated and used, up to the beginning of the twentieth century, to legitimize a threatening image of Judaism and Jews. Despite the changing historical context, that image remained virtually intact throughout the centuries, allowing these same texts to be used time and time again to 'prove' that it was a faithful reflection of reality. Although historical changes can account for differences in the specific motives that drove each author to use the texts of Sixtus of Siena, those authors all shared the same image of Judaism and the Jews, and they considered these texts-cited as an authoritative source, legitimizing their point of view-to be effective in support of their cause. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide empirical evidence on the neighboring effects of Internet adoption as measured by the percentage of firms with their own website in the European regions. This is the first study that explicitly analyzes the role played by spatial effects to explain website adoption for the European case. A set of instruments and techniques commonly used in the spatial econometrics framework is employed to test the hypothesis that proximity matters when explaining Internet adoption by firms. Results show that firms in physically adjacent regions register a similar degree of Internet adoption, confirming the presence in this context of positive spatial dependence. Nevertheless, the spatial effects detected are mainly constrained by national borders. Gross domestic product (GDP) per capita, population density, sectoral composition, and education are positively related to geographic distribution of Internet adoption in the enlarged European Union. In addition, regional disparities in Internet adoption were found to be less important than territorial inequalities in GDP per capita. [ABSTRACT FROM AUTHOR]

In recent years, there has been a growing interest in the problems caused by the existence of instability in cross-sectional regressions. The results about local autocorrelation measures are part of this debate, as are the proposals concerning the concept of geographically weighted regressions. This article also deals with the problem of stability (or the lack thereof), but focusing the discussion on the supposition of constancy in the parameter of spatial dependence. In most cases, this assumption is treated, with the risks that this involves, as a maintained hypothesis, which should be ascertained before continuing with the modeling exercise. In the article, we present a simple heterogeneity test for this type of parameters, based on the Lagrange Multiplier principle. To illustrate its use, we take the distribution of per capita income among the European regions as our discussion case. According to our results, there are clear signs of structural breaks in the spatial distribution of this variable and the scale factor and the autocorrelation coefficient appear to be principal actors. [ABSTRACT FROM AUTHOR]

This review aimed at determining the prevalence and incidence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in Europe. We conducted a primary search in Scopus, PubMed and Web of Science for publications between 1994 and 15 June 2019 (PROSPERO: CRD42017078688). Additionally, we performed a backward-(reference lists) and forward-(citations) search of the works included in this review. Grey literature was addressed by contacting all members of the European Network on ME/CFS (EUROMENE). Independent reviewers searched, screened and selected studies, extracted data and evaluated the methodological and reporting quality. For prevalence, two studies in adults and one study in adolescents were included. Prevalence ranged from 0.1% to 2.2%. Two studies also included incidence estimates. In conclusion, studies on the prevalence and incidence of ME/CFS in Europe were scarce. Our findings point to the pressing need for well-designed and statistically powered epidemiological studies. To overcome the shortcomings of the current state-of-the-art, EUROMENE recommends that future research is better conducted in the community, reviewing the clinical history of potential cases, obtaining additional objective information (when needed) and using adequate ME/CFS case definitions; namely, the Centers for Disease Control & Prevention−1994, Canadian Consensus Criteria, or Institute of Medicine criteria. [ABSTRACT FROM AUTHOR]

Background: Ongoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings., Methods and Participants: We developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed the Checklist for Reporting Results of Internet E-Surveys guideline., Results: The questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries were recorded. The highest educational needs were 'professional development', 'prevention and lifestyle intervention'. Older age, more working experience in rheumatology and higher education levels were positively associated with higher postgraduate educational readiness. While more than half of the HPR were familiar with EULAR as an association and the respondents reported an increased interest in the content of the educational offerings, the courses and the annual congress were poorly attended due to a lack of awareness, comparatively high costs and language barriers., Conclusions: To promote the uptake of EULAR educational offerings, attention is needed to increase awareness among national organisations, offer accessible participation costs, and address language barriers., Competing Interests: Competing interests: VR, LS, MRRA, MB, CB, JC, TD, JdlT, AdT, AD, FE-L, RJOF, GEF, JG, KK, MLK, CM-B, AM, JM, RHM, ElM, ErM, CN-S: no competing interest to declare. RD: Speaker fees from Abbvie, Elly Lilly, EwoPharma, Sandoz, and Novartis, all outside the submitted work., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Non-adherence to treatment could preclude reaching an optimal outcome. Thirty to 80% of patients with rheumatic and musculoskeletal diseases (RMDs) do not adhere to the agreed treatment., Objectives: The objective was to establish points to consider (PtCs) for the prevention, screening, assessment and management of non-adherence to (non-)pharmacological treatments in people with RMDs., Methods: An EULAR task force (TF) was established, and the EULAR standardised operating procedures for the development of PtCs were followed. The TF included healthcare providers (HCPs), comprising rheumatologists, nurses, pharmacists, psychologists, physiotherapists, occupational therapists and patient-representatives from 12 European countries. A review of systematic reviews was conducted in advance to support the TF in formulating the PtCs. The level of agreement among the TF was established by anonymous online voting., Results: Four overarching principles and nine PtCs were formulated. The PtCs reflect the phases of action on non-adherence. HCPs should assess and discuss adherence with patients on a regular basis and support patients to treatment adherence. As adherence is an agreed behaviour, the treatment has to be tailored to the patients' needs. The level of agreement ranged from 9.5 to 9.9 out of 10., Conclusions: These PtCs can help HCPs to support people with RMDs to be more adherent to the agreed treatment plan. The basic scheme being prevent non-adherence by bonding with the patient and building trust, overcoming structural barriers, assessing in a blame-free environment and tailoring the solution to the problem., Competing Interests: Competing interests: TAS has received grant/research support from AbbVie, and Roche, has been consultant for AbbVie, Sanofi Genzyme, and has been paid speaker for AbbVie, Roche and Sanofi. DA has received grant/research support from AbbVie, Amgen, Celgene, Lilly, Medac, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi Genzyme and UCB, has been consultant for AbbVie, Amgen, Celgene, Lilly, Medac, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi Genzyme and UCB and has been paid speaker for AbbVie, Amgen, Celgene, Lilly, Medac, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi Genzyme and UCB. JWJB has received grant/research support from Roche, and has been paid speaker for Roche and Lilly. RGD has been paid speaker for MSD, AbbVie, Novartis, Roche, Pfizer, Myllan and Sandoz. ED has received grant/research support from Independent Learning, Pfizer, combined funding for a research fellow from Celgene, Abbvie and Novartis, and has been paid instructor for Novartis to deliver training to nurses. LG has received grant/research support from Lilly, Pfizer and Sandoz, and has been consultant for AbbVie, Amgen, Biogen, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, Sanofi-Aventis and UCB Pharma. BJFvdB has been paid speaker for MSD, Abbvie and Biogen. MV has been paid speaker for Pfizer. AdT has received grants from Novartis, and has been paid speaker for Lilly and Pfizer. LC has received grant/research support through her institute from Novartis, Pfizer, MSD, Roche, Sanofi Aventis, AbbVie and Gebro Pharma., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Designed by a group of ME/CFS researchers and health professionals, the European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE) has received funding from the European Cooperation in Science and Technology (COST)-COST action 15111-from 2016 to 2020. The main goal of the Cost Action was to assess the existing knowledge and experience on health care delivery for people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in European countries, and to enhance coordinated research and health care provision in this field. We report our findings and make recommendations for clinical diagnosis, health services and care for people with ME/CFS in Europe, as prepared by the group of clinicians and researchers from 22 countries and 55 European health professionals and researchers, who have been informed by people with ME/CFS.

Introduction: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic disease involving central nervous system and immune system disorders, as well as cardiovascular abnormalities. ME/CFS is characterised by severe chronic fatigue lasting for at least 6 months, including clinical symptoms such as tender cervical or axillary lymph nodes, muscle pain, joint pain without swelling or redness, post-exertional malaise for more than 24 hours and unrefreshing sleep. Studies on the epidemiology of ME/CFS in Europe only include single countries and, therefore, the prevalence and incidence of ME/CFS in Europe (as a whole) is unknown. One of the purposes of the European Network on ME/CFS (EUROMENE; European Union-funded COST Action; Reference number: 15111) is to address this gap in knowledge. We will systematically review the literature reporting figures from European countries to provide a robust summary and identify new challenges., Methods and Analysis: We will systematically search the literature databases Scopus, PubMed and Web of Science for studies published in the last 10 years (ie, after 2007). No language restriction will be applied. Two independent reviewers will search, screen and select studies as well as extract data about their main characteristics and evaluate their methodological and reporting quality. When disagreements emerge, the reviewers will discuss to reach a consensus. We plan to produce a narrative summary of our findings as we anticipate that studies are scarce and heterogeneous. The possibility of performing meta-analyses will be discussed in a EUROMENE meeting., Ethics and Dissemination: Ethical approval is not required as only publicly available data will be included. Findings will be described in EUROMENE reports, published in peer-reviewed journal(s) and presented at conferences. The findings will be also communicated to policy-makers, healthcare providers, people with ME/CFS and other sections of society through regular channels including the mass-media., Prospero Registration Number: CRD42017078688., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)