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Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. Design: A multi‐country, phenomenological, qualitative study. Methods: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Results: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. Conclusions: A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. Implications for the profession: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Impact: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Public Contribution: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement. [ABSTRACT FROM AUTHOR]

Aim: To provide initial data regarding country‐specific evidence of workplace violence towards nurses working within the health sector in five European countries. Methods: This is a descriptive and cross‐sectional pilot study, conducted in June 2016. The sample consisted of 260 nurses working in selected health care settings in five participating countries (Poland, Czech Republic, Slovakia, Turkey, and Spain). The questionnaire used was adapted from the International Labour Office/International Council of Nurses/World Health Organisation/Public Services International Workplace Violence in the Health Sector Country Case Study—Questionnaire. Results: A large number of participants confirmed that they had been physically attacked or verbally abused in the workplace in the last 12 months. In most cases, the physical and verbal abuse was inflicted by patients and to a lesser degree by relatives of patients, staff members, or managers/supervisors. In the majority of cases, no action was taken to investigate the causes of the incidents. In most cases, participants believed there was no point in reporting the incidents. However, the reasons for not reporting or discussing incidents of workplace violence varied depending on the country. Conclusion: Workplace violence towards nurses is a serious problem internationally, and violence prevention strategies need to be implemented. SUMMARY STATEMENT: What is already known about this topic? The nursing profession is at high risk of workplace violence. However, the problem seems to be severely underreported.What this paper adds? A better understanding of the problem in the social and cultural context, together with data fill information gaps regarding workplace violence in selected European countries.The implications of this paper: On the basis of the data obtained, prevention programmes and recommendations can be established and implemented in nurses' daily lives. Evaluation can also be conducted of the effectiveness of existing programmes and standards. [ABSTRACT FROM AUTHOR]

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

Adequate follow-up in celiac disease is important to improve dietary compliance and treat disease-related symptoms and possible complications. However, data on the follow-up of celiac children is scarce. We aimed to assess current pediatric celiac follow-up practices across Europe. Pediatricians and pediatric gastroenterologists from 35 countries in Europe, Israel, Turkey, and Russia completed an anonymous survey which comprised a 52-item questionnaire developed by the ESPGHAN Special Interest Group on Celiac Disease. A total of 911 physicians, the majority of whom exclusively worked in pediatric care (83%) and academic institutions (60%), completed the questionnaire. Mean age and mean experience with celiac care were 48.7 years (± 10.6) and 15.7 years (± 9.9), respectively. The vast majority (≥ 92%) always assessed anthropometry, dietary adherence, and tissue-transglutaminase IgA-antibodies at every visit, with the first visit being between 3 and 6 months after diagnosis. Other parameters (% always tested) were as follows: complete blood count (60%), iron status (48%), liver enzymes (42%), thyroid function (38%), and vitamin D (26%). Quality of life was never assessed by 35% of the responding physicians. Transition to adult care was mostly completed via a written transition report (37%) or no formal transition at all (27%). Conclusions: Follow-up of celiac children and adolescents in Europe may be improved, especially regarding a more rational use of (laboratory) tests, dietary and QoL assessment, and transition to adult care. Evidence-based advice from international scientific societies is needed. What is Known: • Follow-up in celiac disease is important to treat disease-related symptoms, improve dietary compliance, and prevent possible complications. • There is a lack of consensus about the appropriate follow-up. What is New: • Almost all European physicians assess anthropometry, tissue-transglutaminase IgA-antibodies, and dietary adherence at every visit, but there are large variations in other follow-up aspects. • Follow-up could be improved by a more rational use of (laboratory) tests, increased intention to dietary compliance, and quality of life together with transition programs to adult care. [ABSTRACT FROM AUTHOR]

This paper reports on an investigation examining provision of physical education continuing professional development (CPD) in European countries undertaken to identify the types of practices being employed. We begin by providing a brief overview of what we currently know about CPD internationally in general education and physical education. Data are reported to reflect Parker and Patton's (2017) key characteristics of CPD that highlight effective CPD, summarise current trends and issues in physical education, and are intended to serve as a guide to how teachers learn and how they might be better served in that learning in these European countries. Studying current practices in CPD provision identified in this study provided modest insight to inform teacher education programmes and CPD providers on the current status of physical education CPD currently being employed in Europe. We propose these findings might inform international and comparative education with respect to CPD and set the foundation for physical education colleagues in Europe to develop a CPD network where endeavours such as sharing of CPD practices, engaging in discussion of those practices, and the design of collaborative research on such CPD practices are based.

Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern Mediterranean Region (EMRO). It induces both acute and chronic hepatic disorders with subsequent liver cirrhosis and hepatocellular carcinoma (HCC) in a considerable percentage of patients based on the age of exposure. In this review, hepatitis B virus (HBV) and HCC prevalence, distribution and prevalence of different genotypes, and male/female infection frequencies in relation to the vaccination status in the Mediterranean countries were reported. Study Design. This systematic review describes the prevalence of hepatitis B infection, genotype distribution of hepatitis B virus, and prevalence and incidence of hepatocellular carcinoma in Mediterranean countries belonging to three different continents: Southern Europe (Spain, France, Italy, Croatia, and Greece), North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt), and the Near East region (Syria, Lebanon, Turkey, Israel, and Palestine). We tried to collect new data from electronic databases: PubMed, ScienceDirect, ResearchGate, Google Scholar, and public health reports between 1980 and 2019. For each publication, we recorded reference, publication year, study characteristics (date, locations, sample size, and study population), and participant characteristics (population group, year, age, and sex). No language limitation was imposed, and articles or reports from non-peer-reviewed sources were not considered for this analysis. The main keywords were HBV prevalence, hepatitis B infection, HBV genotype, and HCC. Inclusion and Exclusion Criteria. Healthy population-based studies included the following sample populations: (i) voluntary blood donors, (ii) pregnant women, (iii) community studies, (iv) hemodialysis patients, (v) hospitalized patients, (vi) healthcare workers, (vii) sex workers, (viii) drug abusers, and (ix) prisoners. We excluded studies from the following special groups who were assumed to be at a special high risk: patients from sexually transmitted disease clinics and thalassemia clinics and professional or paid blood donors. [ABSTRACT FROM AUTHOR]

In contrast to the expectations of an increase in annual fire activity and the severity of fire season due to climate change and large fires, which have been occurring in recent years, a downtrend has been identified in fire activity in many studies conducted for the whole of Europe in recent years. Similarly, in Turkey, according to the General Directorate of Forestry statistics, while there is an increase in the number of annual fires, the burnt area has a downtrend pattern. In this study, fire activity and climate data statistics for Turkey were examined along with the fire season length and severity. The results obtained conform with the studies conducted in places from Spain at the westernmost part of Mediterranean Europe to Israel at the easternmost part of the Mediterranean. Considering the changes in temperatures, temperature rise of 2 to 3 °C was detected at all stations in the study area. No decrease was observed in the average temperatures at any of the stations within the study period between 1940 and 2018. On the other hand, the precipitation trend varied according to the stations. Although there have been increases in precipitation in Fethiye, Isparta, and Marmaris since 1960, the decrease in precipitation by 132 mm in Afyon since 1970 and the decrease in precipitation by 137 mm in Bodrum since 1940 are attention-grabbing. These stations are followed by Izmir station with 66 mm and Cesme station with 37 mm of decrease, despite being smaller decreases. In the study, the long-term (1940-2018) data of the meteorological stations discussed within the study, the Canadian Fire Weather Index (FWI) and the Fine Fuel Moisture Code (FFMC) values were calculated. According to the FWI results used in determining the severity and length of fire season on the coastline of Turkey from the northern Aegean to Antalya, the likelihood of large fires decreased by about 52% in 2018 compared to 1970. This decrease in FWI value indicates that the fire severity is reduced. The specified decrease in fire severity also explains the reason of the decrease in the burnt area that occurred over the years in Turkey. No significant change was observed in the FFMC values indicating the possibility of human-induced fires between 1970 and 2018.

Background: Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management. The aim of this study is to explore lifestyle changes as well as the achievement of targets for risk factors in patients with established cardiovascular disease. Methods: Cross-sectional study conducted in primary care practices. The study was carried out in six European countries (Croatia, France, Portugal, Slovenia, Spain and Turkey). Patients with established cardiovascular disease (coronary heart disease and stroke) attended in primary care were selected and assessed from January to June 2016. Patients were recruited and assessed at the practice by research assistants between 6 months and 3 years after the event. Statistical comparisons were done with the unpaired two-sided Student's t-test for continuous variables and Chi-square test for categorical variables. Results: Nine hundred and seventy-three patients (32.4% females) were assessed. About 14% of them were smokers, 32% were physically inactive, and 30% had nutritionally poor eating behaviours. LDL cholesterol target value below 70 mg/dl was achieved in about 23% of patients, and in general, women were less cardio-protected by drugs than men. Conclusions: Many patients with established cardiovascular disease who attended in general practice still fail to achieve the lifestyle, risk factor, and therapeutic targets set by European guidelines. These results are relevant to general practitioners because these patients have a high risk of subsequent cardiovascular events, including MI, stroke, and death. [ABSTRACT FROM AUTHOR]

This article presents a bibliometric study of 200 European publications released between 2001 and 2016, about the contamination of mushrooms by selected elements. The analysis includes figures on the type of analyte, its concentration, the species of fungi, and its country of origin. In the literature review, 492 species of mushrooms (wild-growing and cultured) found in 26 European countries and their concentration of 74 associated elements were analysed. The papers, which dealt mainly with the heavy metal (Cd, Cu, Fe, Pb, and Zn) concentrations of mushrooms, primarily came from Turkey, Poland, Spain, and the Czech Republic. More than 50% of the publications provided data about edible mushrooms. The results of the bibliometric analysis showed that over the 16 years, European research on fungal contamination by selected analytes has not lessened in popularity and is ongoing. Many of the studies underlined the need to assess the risk to human health arising from the consumption of contaminated mushrooms taken from various habitats. These results were the effect of, among other things, the strong interest in studies carried out on edible species, in which concentrations of mainly heavy metals that are dangerous to health and are marked were indicated (Cd, Pb, and Hg).