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

Background: The Sarcoma Policy Checklist was created by a multidisciplinary expert group to provide policymakers with priority areas to improve care for sarcoma patients.Main Body: This paper draws on this research, by looking more closely at how France, Germany, Italy, Spain, Sweden and the United Kingdom are addressing each of these priority areas. It aims to highlight key gaps in research, policy and practice, as well as ongoing initiatives that may impact the future care of sarcoma patients in different European countries. A pragmatic review of the published and web-based literature was undertaken. Telephone interviews were conducted in each country with clinical and patient experts to substantiate findings. Research findings were discussed within the expert group and developed into five core policy recommendations. The five identified priority areas were: the development of designated and accredited centres of reference; more professional training; multidisciplinary care; greater incentives for research and innovation; and more rapid access to effective treatments. Most of the countries studied have ongoing initiatives addressing many of these priorities; however, many are in early stages of development, or require additional funding and resources.Conclusion: Gaps in access to quality care are particularly concerning in many of Europe's lower-resourced countries. Equitable access to information, clinical trials, innovative treatments and quality specialist care should be available to all sarcoma patients. Achieving this across Europe will require close collaboration between all stakeholders at both the national and European level. [ABSTRACT FROM AUTHOR]

Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries. [ABSTRACT FROM AUTHOR]

The paper questions the view of a narrow connection between global constraints and internal policy choices of European nation states according to which 'Deregulation' and the reduction of state expenditure are seen as the only possibilities that decision-makers in labour market and social policy have at their disposal. Theoretically, it is argued that countries with relatively high taxes can remain attractive for international capital as long as they offer a highly qualified labour force able to produce high quality commodities. Different productivity levels then correspond with a spectrum of post-Fordist growth strategies the ends of which are characterised as 'capital-oriented flexibility' and 'negotiated flexibility'. Empirically, the paper interprets recent reforms of labour markets and welfare states in the Netherlands, the UK, Sweden, Spain, and Germany. [ABSTRACT FROM AUTHOR]

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

The current COVID-19 pandemic has come to impact all areas of life involving the health, psycho-social and economic wellbeing of individuals, as well as all stages of life from childhood to old age. Particularly, the frail elderly have had to face the gravest consequences of the disease; while reporting measures tend to differ between countries making direct comparisons difficult, national statistics worldwide point to a disproportionate and staggering share of COVID-19 related mortality coming from residential long-term care facilities (LTCFs). Still, the severity of the impact on the institutionalized elderly has not been uniform across countries. In an effort to better understand the disparities in impact on Europe's elderly living in LTCFs, we review data on mortality outcomes seen during the first wave of the pandemic (months March to June 2020). We then set out to understand the role played by the following two factors: (1) the infection rate in the general population and (2) member state adherence to policy recommendations put forth by the European Centre for Disease Prevention and Control (ECDC) targeting the LTC sector. Regarding the latter, we compare the content of national policy measures in six countries – Austria, Denmark, Germany, Ireland, Spain and Sweden – with those of the ECDC. Our findings establish that infection rates in the general population accounted for most of the variation in mortality among member states, however adherence to EU policy helped to explain the residual variation between cases. This suggests that in order to best protect the institutionalized elderly from infectious disease of this kind, countries need to adopt a two-pronged approach to developing measures: one that aims at reducing transmission within the general population and one that specifically targets LTCFs. [ABSTRACT FROM AUTHOR]

Background In responding to Covid-19, governments have tried to balance protecting health while minimizing gross domestic product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalizations and deaths under 'mitigation' to modelled events under 'no mitigation' to 20 July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at £20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared with Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Results The UK saved 3.17 (0.32–3.65) million QALYs, £33 (8–38) billion healthcare costs and £1416 (220–1637) HRNB per capita at £20,000/QALY. Per capita, this is comparable to £1455 GDP loss using Sweden as comparator and offsets 46.1 (7.1–53.2)% of total £3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Conclusions Our exploratory analysis indicates the benefit of government Covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several studies have been performed on the relationship between working conditions and health. Numerous parameters still require further study, including working hours and obesity among different groups, specifically older workers in national, regional, and international levels. OBJECTIVE: Working hours have considerable effects on the socio-cultural, psychological, and economic aspects of people's lives and health. While long working hours increases income level and raises living standards, it increases the risk of certain health problems. This study investigated whether working hours are associated with obesity in upper-middle-aged workers. METHODS: The Survey of Health, Ageing and Retirement in Europe (SHARE) dataset was used for the analyses. Analyses were carried out by means of a Cox regression of the panel dataset created with the data in question, surveyed by European Commission to 12,000 participants. RESULTS: The survey was performed in Austria, Belgium, Switzerland, Germany, Denmark, Spain, France, Greece, Italy, the Netherlands, Sweden, the Czech Republic, Poland, and Ireland. We found that in most countries, especially Sweden and the Netherlands, upper-middle-aged employees working > 59 hours per week are more likely to gain weight than their counterparts working < 59 hours. CONCLUSIONS: Our findings raise awareness of obesity in older workers, and highlight the need to regulate working conditions and hours in the European Union and other countries. [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.

Aims and objectives: To examine the association between registered nurses' (referred to as "nurses" for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers. Background: The introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps. Design: Cross‐sectional survey of 31,627 nurses within 487 hospitals in 12 European countries. Methods: The associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist. Results: When nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant. Conclusion: Working shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care. Relevance to clinical practice: Implementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients. [ABSTRACT FROM AUTHOR]

Purpose: This study illustrates the huge untapped potential of quantifying the impact of culture in making meaningful comparisons across groups. Our focus is on cross‐national differences in nurses' reports of their relations with physicians, and how the measurement of this complex construct and the evaluation of true differences are related to dimensions of national culture. Design: We examine across 14 European countries the association between indices of national culture from the seminal work of Hofstede and 39,435 nurses' ratings of their relations with physicians. Multilevel confirmatory factor analysis was used to evaluate strong factorial invariance across countries and to examine the influence of power distance and masculinity. Findings: There was wide variation across countries in nurses' reports of their relations with physicians. Strong factorial invariance was shown for a one‐factor model, which confirmed that across countries the seven survey items measure a common factor of physician‐nurse relations. This model showed no country bias for any of the seven survey items, which suggests that differences across countries reflect true differences. These true differences were significantly associated with variation in country values of power distance, which showed a significant negative correlation with physician–nurse relations. Conclusions: Continuously pursuing a better understanding of characteristics that impact the studied indicators, such as national culture, is elementary to better understand the construct under study. In this application, country values of power distance negatively impacted nurse‐reported relations with physicians, which strongly varied across countries. Clinical Relevance: Better nurse‐reported relations between nurses and physicians link to higher nurse job satisfaction, lower emotional exhaustion, better nurse‐perceived quality of care, and lower patient mortality. The Practice Environment Scale of the Nursing Work Index is an excellent instrument to characterize variation in working relations between nurses and physicians as well as physicians' professional posture towards nurses. [ABSTRACT FROM AUTHOR]

Scholarly studies of international student mobility programs have increased during the last two decades, particularly following the Bologna Declaration. Nevertheless, a systematic review of international student mobility programs and the outcomes and benefits derived from participation in such programs has not been undertaken. This paper provides a comprehensive review of studies examining the various outcomes of student participation in short-term international mobility programs and identifies under-researched areas such as employment and career outcomes. A future research agenda based on the review is outlined, along with recommendations for improving research designs in order to increase our understanding of the short- and long-term outcomes of international student mobility programs.

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

Purpose: Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH.Methods: Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index.Results: The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function.Conclusions: Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care. [ABSTRACT FROM AUTHOR]

Information about several topics discussed at the meeting of European Nutrition Foundations in Madrid on April 2010 is presented. Topics of the meeting include the nutrition in the school curriculum and regulations on foods and drinks provided in schools. The meeting features various executives including Juan Ballasteros.

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

The European pharmaceutical industry uses the alleged efficacy of self-regulation to question the need for transparency laws similar to the US Physician Payment Sunshine Act. We conducted a comparative analysis of 20 large companies' payment disclosures in seven European countries in 2017-2019. The data was extracted as part of eurosfordocs.eu, a novel transparency project that scrapes and integrates publicly available databases and disclosures. Our analysis of EUR 735 million showed marked differences in country payment patterns. For example, payment totals per registered doctor were substantially larger in Spain and lowest in Sweden. There were significant country and company differences in individualized data completeness. Only 19% of totals were reported with recipient names in Germany, compared to Ireland (59%), the United Kingdom (60%), Italy (67%), Switzerland (73%), Sweden (79%) and Spain (100%), with little or no improvement over time. Payment data in Spain was particularly difficult to extract. Thus, in no country did self-regulation generate comprehensive individualized data allowing for building an accurate picture of financial relationships between the industry and healthcare professionals. We conclude that the cultures and policies of countries and companies create structural problems of data inaccessibility and incompleteness within the self-regulatory framework. Therefore, this study supports calls for a Europe-wide "Sunshine Act" to achieve real transparency of drug company payments., Competing Interests: Declaration of Competing Interest SM's partner is employed by PRA Health Sciences, a global Contract Research Organization whose costumers include many pharmaceutical companies. LM and PAJ are members of Euros for Docs, a non-profit organization registered in France that seeks to promote transparency of drug company funding in the healthcare sector by making payment data accessible and complete across Europe. PAJ is employed by Haute Autorité de Santé, the French independent health technology assessment organisation. PO's PhD student was supported by a grant from Sigma Pharmaceuticals, a UK pharmacy wholesaler and distributor (not a pharmaceutical company). The PhD work funded by Sigma Pharmaceuticals is unrelated to the subject of this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

In recent years, there has been a revival of the term "structural violence (SV)" which was coined by Johan Galtung in the 1960s in the context of Peace Studies. "Structural violence" refers to social structures-economic, legal, political, religious, and cultural-that prevent individuals, groups and societies from reaching their full potential. In the European context, very few studies have investigated health and well-being using an SV perspective. Therefore, this paper sought to systematically and descriptively review studies that used an SV framework to examine health-related outcomes across European countries. The review included two studies each from Spain and France, one each from the UK, Ukraine and Russia, and another study including the three countries Sweden, Portugal and Germany. With the exception of one mixed-method study, the studies used a qualitative design. Furthermore, the eight studies in the review used different conceptualizations of SV, which indicates the complexity of using SV as a concept in public health in the European context. Future research that attempts to identify and standardize measures of SV is needed; the knowledge gained is hoped to inform appropriate interventions aiming to reduce the effects of SV on population health.

Since 2015, a series of papers which describe the systems for the provision of health and oral healthcare in nine European Union (EU) countries (France, Germany, Greece, Ireland, Italy, Poland, Romania, Spain and Sweden) have been published in this journal. This tenth and final paper in the series compares aspects of the systems for each country, with each other and with that in the United Kingdom (UK). The topics which have been covered are the organisation and funding of oral healthcare, national populations and oral healthcare workforce, education of dentists, uptake of oral healthcare, expenditure on oral healthcare and oral epidemiology. The comparison shows that there are wide differences between the care provision systems between the individual countries. In all of them, oral healthcare continues to operate outside the mainstream healthcare systems. In particular, the proportion of costs paid for them from public funds, raised through taxation or through compulsory social insurances, and those paid for by individual patients varies greatly. No comparable data exist on quality of care.

This paper examines influenza vaccine coverage using a population base of an average of 2300 persons in each of four European countries (Germany, Spain, Poland and Sweden). The reasons for non-vaccination of those in the high-risk groups were explored by questionnaire. The vaccine coverage rate (VCR) for elderly ranged from 18% in Poland to 67% in Spain. The VCR for high-risk population under 65 was 10% in Poland, 13% in Sweden, 27% in Germany and 30% in Spain. The most important reasons mentioned for not being vaccinated were: perceived sufficient resistance to flu (33-42%) in all countries; financial barriers in Poland (25%), and not to qualify for the vaccination (30%) and forgetfulness (20%) in Germany. Receiving a personal invitation for the vaccination, results in higher coverage rates in all four countries. We think that future interventions could be directed towards: an information campaign with special attention to the high-risk groups due to disease; promotion of personal invitations; and, for Poland, solving financial barriers to vaccination.