Search

Background and aim: The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) aims to further develop its role in international medical and scientific guidance in the field of Clinical Microbiology and Infectious Diseases, where many types of guidance documents exist. The ESCMID Executive Committee and the Clinical Microbiology and Infection (CMI) editorial board wish to clarify the terminology and format to be used in ESCMID guidance documents submitted for publication in CMI, and to highlight the principles behind ESCMID guidance documents.Types of guidance documents: There are five types of ESCMID guidance documents: White Papers, Clinical Practice Guidelines, Consensus Statements, State-of-the-Science Statements, and Position Papers. They differ in scope, methods of development, drafting group composition and preferred publication format. Guidance documents can be proposed, developed and published by ESCMID Study Groups, Committees and individual members; often, other scientific societies are involved. The full disclosure of potential conflicts of interest of all drafting group members is a requirement.Final remarks: Guidance documents constitute a common cultural and scientific background to people in the same and related professions. Also, they are an important educational and training tool. Developing a guidance document is a scientific endeavour, where a sound and transparent development process is needed, requiring multidisciplinary and personal skills. (C) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Background In early March 2020, a SARS-CoV-2 outbreak in the ski resort Ischgl in Austria triggered the spread of SARS-CoV-2 throughout Austria and Northern Europe. In a previous study, we found that the seroprevalence in the adult population of Ischgl had reached 45% by the end of April, representing an exceptionally high level of local seropositivity in Europe. We performed a follow-up study in Ischgl, which is the first to show persistence of immunity and protection against SARS-CoV-2 and some of its variants at a community level. Methods Of the 1259 adults that participated in the baseline study, 801 have been included in the follow-up in November 2020. The study involved the analysis of binding and neutralizing antibodies and T cell responses. In addition, the incidence of SARS-CoV-2 and its variants in Ischgl was compared to the incidence in similar municipalities in Tyrol until April 2021. Findings For the 801 individuals that participated in both studies, the seroprevalence declined from 51.4% (95% confidence interval (CI) 47.9-54.9) to 45.4% (95% CI 42.0-49.0). Median antibody concentrations dropped considerably (5.345, 95% CI 4.833 - 6.123 to 2.298, 95% CI 2.141 - 2.527) but antibody avidity increased (17.02, 95% CI 16.49 - 17.94 to 42.46, 95% CI 41.06 - 46.26). Only one person had lost detectable antibodies and T cell responses. In parallel to this persistent immunity, we observed that Ischgl was relatively spared, compared to similar municipalities, from the prominent second COVID-19 wave that hit Austria in November 2020. In addition, we used sequencing data to show that the local immunity acquired from wild-type infections also helped to curb infections from variants of SARS-CoV-2 which spread in Austria since January 2021. Interpretation The relatively high level of seroprevalence (40-45%) in Ischgl persisted and might have been associated with the observed protection of Ischgl residents against virus infection during the second COVID-19 wave as well as against variant spread in 2021. Funding Funding was provided by the government of Tyrol and the FWF Austrian Science Fund.

BACKGROUND: Globally, trans people are disproportionately affected by HIV, but research on strategies to increase testing are limited. SELPHI is a randomised-controlled-trial (RCT) of 10,135 cis men, trans men, and trans women reporting lifetime anal intercourse with male partners (cis or trans), evaluating whether the offer of free HIV self-testing (HIVST) increases diagnosis. This subgroup analysis from the SELPHI RCT aims to describe key HIVST outcomes and HIVST acceptability for trans people. METHODS: SELPHI recruited using social networking and trans focused social media. Participants were randomised 60/40 to baseline HIVST (Biosure™) (BT) vs no baseline HIVST (nBT); and at 3-months (if completed the survey and reported recent CAI) 50/50 to 3-monthly HIVST (RT) vs no repeat HIVST (nRT). Outcomes were self-reported through online surveys. We conducted a qualitative study of semi-structured peer-led participant interviews (n = 20) exploring HIVST motivations and experiences. These were analysed using a framework approach. FINDINGS: SELPHI recruited and randomised 118 trans men and trans women (94 trans men, 24 trans women), of whom 20 (16 trans men, 4 trans women) underwent the second randomisation. Median age at baseline was 29 (IQR: 22, 37), 79% were white, 79% were UK born, 37% had degree level education, and 31% had never tested for HIV. 62% (n = 59) of trans men completed the 3-month survey, but survey completion by trans women in nBT was too low (1/11) for randomised comparison. In trans men HIV testing uptake by 3 months was significantly higher in BT (95% 36/38) vs nBT (29%, 6/21) (RR=3.32 (1.68, 6.55) p

Summary Background Approximately 164,000 deaths yearly are due to shigellosis, primarily in developing countries. Thus, a safe and affordable Shigella vaccine is an important public health priority. The GSK Vaccines Institute for Global Health (GVGH) developed a candidate Shigella sonnei vaccine (1790GAHB) using the Generalized Modules for Membrane Antigens (GMMA) technology. The paper reports results of 1790GAHB Phase 1 studies in healthy European adults. Methods To evaluate the safety and immunogenicity profiles of 1790GAHB, we performed two parallel, phase 1, observer-blind, randomized, placebo-controlled, dose escalation studies in France (“study 1”) and the United Kingdom (“study 2”) between February 2014 and April 2015 (ClinicalTrials.gov, number NCT02017899 and NCT02034500, respectively) in 18–45 years old subjects (50 in study 1, 52 in study 2). Increasing doses of Alhydrogel adsorbed 1790, expressed by both O Antigen (OAg) and protein quantity, or placebo were given either by intramuscular route (0.059/1, 0.29/5, 1.5/25, 2.9/50, 5.9/100 μg of OAg/μg of protein; study 1) or by intradermal (ID), intranasal (IN) or intramuscular (IM) route of immunization (0.0059/0.1, 0.059/1, 0.59/10 μg ID, 0.29/5, 1.2/20, 4.8/80 μg IN and 0.29/5 μg IM, respectively; study 2). In absence of serologic correlates of protection for Shigella sonnei, vaccine induced immunogenicity was compared to anti-LPS antibody in a population naturally exposed to S. sonnei. Findings Vaccines were well tolerated in both studies and no death or vaccine related serious adverse events were reported. In study 1, doses ≥ 1.5/25 μg elicited serum IgG median antibody greater than median level in convalescent subjects after the first dose. No vaccine group in study 2 achieved median antibody greater than the median convalescent antibody. Interpretation Intramuscularly administered Shigella sonnei GMMA vaccine is well tolerated, up to and including 5.9/100 μg and induces antibody to the OAg of at least the same magnitude of those observed following natural exposure to the pathogen. Vaccine administered by ID or IN, although well tolerated, is poorly immunogenic at the doses delivered. The data support the use of the GMMA technology for the development of intramuscular multivalent Shigella vaccines., Highlights • GVGH GMMA vaccine against S. sonnei was well tolerated by IM, IN and ID routes of immunization in young European adults. • Doses ≥ 1.5/25 μg elicited serum IgG median antibody greater than median level in convalescent subjects after the first dose. • Clinical data support the use of the GMMA technology for the development of intramuscular Shigella multivalent vaccines. Shigellosis is an important cause of diarrhoea especially in children of developing countries. No vaccine is available. Based on the 2015 Global Burden of Disease, Shigella caused approximately 164,000 deaths due to diarrhoea in 2015, supporting the public health relevance of the disease and the need for a vaccine. The GMMA (Generalized Modules for Membrane Antigens) technology was used for the development of a vaccine against Shigella sonnei which, tested in these trials for the first time, was shown to be well tolerated in young adults and induced specific antibody titres at least as high as after natural infection.

UNLABELLED: Radical treatment of localised prostate cancer is recognised to be an unnecessary intervention or overtreatment in many men. Consequently, there has been a rapid uptake in the use of focal ablative therapies. However, there are several biological and practical concerns about such approaches as they have yet to be proved as robust treatment options. In particular, the multifocal nature of prostate cancer argues against unifocal treatment, while limitations in imaging can preclude the accurate identification of the number, location, and extent of prostate cancer foci. To date, a number of ablative options have reported results on mainly low-risk disease. Most series are relatively immature, with a lack of consistent follow-up, and the morbidity of retreatment is often not considered. The authors consider focal therapy to be an investigational modality, and encourage prospective recording of outcomes and recruitment of suitable patients. PATIENT SUMMARY: Focal therapy of prostate cancer is the targeted destruction of cancer within a specific part of the prostate gland, sparing the rest of the prostate and nearby tissue. This procedure could potentially reduce side effects when compared with established standard treatments, such as surgery or radiotherapy, which treat the entire prostate. Studies show that for most men with low-risk cancer, active surveillance is the preferred treatment option. However, the available data regarding all forms of focal therapy are still poor and inconclusive. Consequently, due to both the lack of clear results associated with focal therapy and the difficulties in detecting all cancerous areas of the prostate, focal therapy should be considered an investigational modality only. ispartof: EUROPEAN UROLOGY vol:74 issue:1 pages:84-91 ispartof: location:Switzerland status: published

Pneumocystis jirovecii is an airborne human-specific ascomycetous fungus responsible for Pneumocystis pneumonia (PCP) in immunocompromised patients, affecting > 500,000 patients per year (www.gaffi.org). The understanding of its epidemiology is limited by the lack of standardised culture. Recent genotyping data suggests a limited genetic diversity of P. jirovecii. The objective of the study was to assess the diversity of P. jirovecii across European hospitals and analyse P. jirovecii diversity in respect to clinical data obtained from the patients. Genotyping was performed using six already validated short tandem repeat (STR) markers on 249 samples (median: 17 per centre interquartile range [11 − 20]) from PCP patients of 16 European centres. Mixtures of STR markers (i.e., ≥ 2 alleles for ≥ 1 locus) were detected in 67.6% (interquartile range [61.4; 76.5]) of the samples. Mixture was significantly associated with the underlying disease of the patient, with an increased proportion in HIV patients (78.3%) and a decreased proportion in renal transplant recipients (33.3%) (p < 0.001). The distribution of the alleles was significantly different (p < 0.001) according to the centres in three out of six markers. In analysable samples, 201 combinations were observed corresponding to 137 genotypes: 116 genotypes were country-specific; 12 in two; six in three; and two in four and one in five countries. Nine genotypes were recorded more than once in a given country. Genotype 123 (Gt123) was significantly associated with France (14/15, p < 0.001) and Gt16 with Belgium (5/5, p < 0.001). More specifically, Gt123 was observed mainly in France (14/15/16 patients) and in renal transplant patient (13/15). Our study showed the wide population diversity across Europe, with evidence of local clusters of patients harbouring a given genotype. These data suggest a specific association between genotype and underlying disease, with evidence of a different natural history of PCP in HIV patients and renal transplant recipients.

This work studied the processing of biomass mixtures containing three lignocellulosic materials largely available in Southern Europe, eucalyptus residues (ER), wheat straw (WS) and olive tree pruning (OP). The mixtures were chemically characterized, and their pretreatment, by autohydrolysis, evaluated within a severity factor (log R0) ranging from 1.73 up to 4.24. A simple modeling strategy was used to optimize the autohydrolysis conditions based on the chemical characterization of the liquid fraction. The solid fraction was characterized to quantify the polysaccharide and lignin content. The pretreatment conditions for maximal saccharides recovery in the liquid fraction were at a severity range (log R0) of 3.65–3.72, independently of the mixture tested, which suggests that autohydrolysis can effectively process mixtures of lignocellulosic materials for further biochemical conversion processes.

Historically, there has been a debate on the effects of recessions on population health, and especially on mortality and its distribution across different social groups. This paper contributes to this discussion by means of a critical review of the research on the impact of economic recessions on mortality inequalities in the period 1980–2020. We analyzed 19 studies according to their mortality outcomes, socioeconomic indicators, design, analysis, and main findings. Twelve studies focused on European countries or urban areas, two on Asian countries, two on Russia, one on Asia and Europe, one on the USA, and one in Somalia. Five articles included cross-country comparisons (four between European countries or cities and one between Asian and European countries). The Great Recession of 2008 was the most researched economic crisis, followed by country-specific crises in the 90s, the fall of the Soviet Union, and some crises during the 80s. Most studies (n = 15) showed an overall or partial increase in mortality inequalities after an economic recession. However, two papers found a decrease in mortality inequalities due to the worsening of the health of the upper and middle classes, one article found a decrease in inequalities due to a general improvement in population health, and a study found a “slow-down” effect of pre-existent mortality inequalities. Support was provided by the Ramón y Cajal Programme (contract number RYC-2015-17372), funded by the Spanish State Research Agency (AEI), the Spanish Ministry of Science, Innovation and Universities, and the European Social Fund (ESF). Support provided by the UPF Planetary Wellbeing initiative project “Low Carbon Health Systems”. Joan Benach gratefully acknowledges the financial support by ICREA under the ICREA Academia programme.

Highlights • WHO and ILO are developing joint estimates of work-related burden of disease and injury. • This paper synthesizes evidence on prevalence of occupational noise exposure. • 65 studies were included (157,370 participants, 54 countries, six WHO regions). • The prevalence of occupational noise exposure in workers was 0.17., Background The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of individual experts. Evidence from mechanistic and human data suggests that occupational exposure to noise may cause cardiovascular disease. In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to noise for estimating (if feasible) the number of deaths and disability-adjusted life years from cardiovascular disease that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates. Objectives We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to noise. Data sources We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines, and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. Study eligibility and criteria We included working-age (≥15 years) workers in the formal and informal economies in any WHO Member and/or ILO member State, but excluded children (

This paper examines the effect which social network use (SNU) has on individual life satisfaction across 27 different European countries using the 2016 Eurobarometer 86.2 survey from the European Commission (N ​= ​15,039). An ordered probit estimation technique is used to estimate the relationship between SNU and individual life satisfaction. An interaction variable between SNU and country is created and is included in this paper’s estimation to show how SNU affects life satisfaction differently across countries. Findings indicate that there are considerable variations across countries regarding the effect which SNU has on life satisfaction. Overall results show that frequent SNU negatively impacts individual life satisfaction, while moderate SNU positively impacts life satisfaction. However, the negative effect associated with frequent SNU is strongest amongst individuals from countries with higher performing economies while individuals from countries with lower performing economies prove more resilient to the negative effects of SNU. This indicates that excessive SNU is most damaging for individuals from high performing economies. We propose that this effect is due to the poorer endowment of social capital in countries with lower performing economies relative to countries with higher performing economies. This lesser level of social capital means that the beneficial effect which SNU provides to social capital, and in turn life satisfaction, is greater in countries with lower performing economies than it is in countries with higher performing economies. This paper provides an important contribution to literature concerning SNU and life satisfaction by examining and reporting disparities between the effect of SNU on life satisfaction across different countries.

The COVID-19 pandemic and the resulting travel restrictions and fall in consumer demand led to a dramatic and unprecedented reduction in passenger flights across Europe. As borders closed, national Governments advised against all but essential travel and passenger demand disappeared, European airlines were forced to quickly respond to the downturn and impose unprecedented cost saving measures to protect their business. The aim of this paper is to examine the ways in which major European passenger airlines responded to the height of the COVID-19 crisis in the period March – May 2020. Using data from Eurocontrol, the European network manager, the paper identifies the responses individual airline operators and parent companies took to contract and consolidate their operations. The findings show that changes to flight operations, rationalising the fleet, reducing staff numbers, and reconfiguring their networks and capacity were the most common responses. The paper concludes by discussing future considerations for airline business and management as European carriers seek to restructure their operations and adapt to a new post-COVID reality., Highlights • The COVID pandemic has had an unprecedented impact on airlines worldwide. • COVID has challenged conventional airline business strategy and disruption management techniques. • The ways in which 40 European airlines responded to the COVID-19 pandemic is examined. • Findings reveal that contraction and consolidation were key short-term responses. • Implications for post-COVID airline business and management are considered.

Background: Food allergies are a significant public health issue and the only effective management option currently available is strict avoidance of all foods containing the allergen. In view of the practical impossibility to limit risks to zero, quantitative allergen risk assessment and management strategies are needed. Objective: To develop appropriate methods for informing population-based risk assessments and risk management programs to benefit all stakeholders, but particularly food allergic individuals. Methods: Individual thresholds for food allergens (maximum tolerable doses and minimum eliciting doses) can ideally be established through double-blind, placebo-controlled food challenges (DBPCFCs). If DBPCFC data is not available, data from widely used “open” food challenges (OFCs) using pre-defined objective criteria can also provide useful data regarding minimum eliciting doses. For more than 20 years, the Netherlands Organisation for Applied Scientific Research (TNO) and The Food Allergy Research and Resource Program (FARRP) at the University of Nebraska-Lincoln have been collecting individual maximum tolerable doses and minimum eliciting doses that produce objective symptoms from published and unpublished clinical data to better refine knowledge regarding the sensitivity of the population to food allergens. Results: In this paper we provide in depth insights into the methodology applied by TNO and FARRP to derive individual maximum tolerable doses and minimum eliciting doses for objective symptoms from clinical food challenge data. Over 90 examples for determining the individual allergic thresholds are presented. Conclusion: With the methodology presented in this paper, we aim to stimulate harmonization and transparency in quantitative food allergen risk assessment and risk management programs, encouraging their wider adoption.

Aims Estimates of the prevalence of gestational diabetes vary widely. It is important to have a clear understanding of the prevalence of this condition to be able to plan interventions and health care provision. This paper describes a meta-analysis of primary research data reporting the prevalence of gestational diabetes mellitus in the general pregnant population of developed countries in Europe. Methods Four electronic databases were systematically searched in May 2016. English language articles reporting gestational diabetes mellitus prevalence using universal screening in general pregnant population samples from developed countries in Europe were included. All papers identified by the search were screened by one author, and then half screened independently by a second author and half by a third author. Data were extracted by one author. Values for the measures of interest were combined using a random effects model and analysis of the effects of moderator variables was carried out. Results A total of 3258 abstracts were screened, with 40 studies included in the review. Overall prevalence of gestational diabetes mellitus was 5.4% (3.8–7.8). Maternal age, year of data collection, country, area of Europe, week of gestation at testing, and diagnostic criteria were found to have a significant univariate effect on GDM prevalence, and area, week of gestation at testing and year of data collection remained statistically significant in multivariate analysis. Quality category was significant in multivariate but not univariate analysis. Conclusions This meta-analysis shows prevalence of GDM that is at the upper end of previous estimates in Europe.

This paper describes a recent study in the UK aimed at identifying how policy makers might more effectively encourage pro-environmental behaviours amongst their target audiences. The study included analysis and synthesis of theories and models of behaviour change, a range of current policy programmes and instruments and 'real world' practices of individuals, households, groups and organisations.The paper highlights some important considerations for future policy within the UK and, more widely, for other countries aiming to introduce comprehensive and multi-level policy programmes to encourage pro-environmental behaviours. To this end, it emphasises the complex and non-linear nature of environmental behaviours and, thus, the importance of adopting multi-levelled and multi-instrument integrated policies across whole systems of delivery.

Display Omitted A classification system, using a common language, has been developed.The online tool ensures consistency in describing and reporting studies.The classification system can be modified to accommodate technological development.The taxonomy will continue to develop iteratively through feedback from users. BackgroundRecent Cochrane reviews on falls and fall prevention have shown that it is possible to prevent falls in older adults living in the community and in care facilities. Technologies aimed at fall detection, assessment, prediction and prevention are emerging, yet there has been no consistency in describing or reporting on interventions using technologies. With the growth of eHealth and data driven interventions, a common language and classification is required. ObjectiveThe FARSEEING Taxonomy of Technologies was developed as a tool for those in the field of biomedical informatics to classify and characterise components of studies and interventions. MethodsThe Taxonomy Development Group (TDG) comprised experts from across Europe. Through face-to-face meetings and contributions via email, five domains were developed, modified and agreed: Approach; Base; Components of outcome measures; Descriptors of technologies; and Evaluation. Each domain included sub-domains and categories with accompanying definitions. The classification system was tested against published papers and further amendments undertaken, including development of an online tool. Six papers were classified by the TDG with levels of consensus recorded. ResultsTesting the taxonomy with papers highlighted difficulties in definitions across international healthcare systems, together with differences of TDG members' backgrounds. Definitions were clarified and amended accordingly, but some difficulties remained. The taxonomy and manual were large documents leading to a lengthy classification process. The development of the online application enabled a much simpler classification process, as categories and definitions appeared only when relevant. Overall consensus for the classified papers was 70.66%. Consensus scores increased as modifications were made to the taxonomy. ConclusionThe FARSEEING Taxonomy of Technologies presents a common language, which should now be adopted in the field of biomedical informatics. In developing the taxonomy as an online tool, it has become possible to continue to develop and modify the classification system to incorporate new technologies and interventions.

Ten bibliometric indicators were used to assess European publishing intensity in journals listed in Scopus under the subject category “Library and Information Science” between 2003 and 2012. The findings were analyzed for the 20 countries and 25 research institutions with the greatest output in that period. The indicators calculated included normalized impact, number and proportion of highly cited papers and the distribution of papers by the quartiles defined in the Scimago Journal Rank (SJR). SJR is a measure of the scientific influence of scholarly journals that accounts for both the number of citations received by a journal and the importance or prestige of the journals where such citations come from. With SJR, the subject field, quality and reputation of the journal have a direct effect on the value of a citation. The analysis covered 11,931 Western and 939 Eastern European papers published in 149 journals. The highest output growth rates were found for Spain, Poland, Portugal, Italy, Greece and Austria. The highest impact ratings were attained by European institutions whose members are prolific authors of papers on informetrics. On the whole, the articles were written primarily in English, Spanish, German or French, while the publications most widely cited appeared in English language journals. This study presents bibliometric data that shed light on the status of Library and Information Science research in Europe today, in the framework of the European Higher Education Area.

International audience; Security of supply of a number of raw materials is of concern for the European Union; foremost among these are the rare earth elements (REE), which are used in a range of modern technologies. A number of research projects, including the EURARE and ASTER projects, have been funded in Europe to investigate various steps along the REE supply chain. This paper addresses the initial part of that supply chain, namely the potential geological resources of the REE in Europe. Although the REE are not currently mined in Europe, potential resources are known to be widespread, and many are being explored. The most important European resources are associated with alkaline igneous rocks and carbonatites, although REE deposits are also known from a range of other settings. Within Europe, a number of REE metallogenetic belts can be identified on the basis of age, tectonic setting, lithological association and known REE enrichments. This paper reviews those metallogenetic belts and sets them in their geodynamic context. The most well-known of the REE belts are of Precambrian to Palaeozoic age and occur in Greenland and the Fennoscandian Shield. Of particular importance for their REE potential are the Gardar Province of SW Greenland, the Svecofennian Belt and subsequent Mesoproterozoic rifts in Sweden, and the carbonatites of the Central Iapetus Magmatic Province. However, several zones with significant potential for REE deposits are also identified in central, southern and eastern Europe, including examples in the Bohemian Massif, the Iberian Massif, and the Carpathians.

Introduction Public reporting of quality in long-term care is advocated on the basis of allowing providers to improve their performance by benchmarking and supporting users to choose the best providers. Both mechanisms are intended to drive improvements in quality. However, there is relatively scarce comparative research on the experiences and impact of public reporting on quality in long-term care in Europe. Methods Using information gathered from key informants by means of a structured questionnaire and country profiles, this paper discusses experiences with public reporting mechanisms in seven European countries and available information on their impact on quality in long-term care. Results Countries surveyed included a variety of public reporting schemes, ranging from pilot programmes to statutory mechanisms. Public reporting mechanisms more often focus on institutional care. Inspections carried out as part of a legal quality assurance framework are the main source of information gathering, supplemented by provider self-assessments in the context of internal quality management and user satisfaction surveys. Information on quality goes well beyond structural indicators to also include indicators on quality of life of users. Information is displayed using numerical scores (percentages), but also measures such as ratings (similar to school grades) and ticks and crosses. Only one country corrects for case-mix. The internet is the preferred medium of displaying information. Discussion There was little evidence to show whether public reporting has a significant impact on driving users’ choices of provider. Studies reported low awareness of quality indicators among potential end users and information was not always displayed in a convenient format, e.g. through complicated numerical scores. There is scarce evidence of public reporting directly causing improved quality, although the relative youth and the pilot characteristics of some of the schemes covered here could also have contributed to downplay their impact. The establishment of public reporting mechanisms did however contribute to shaping the discussion on quality measurement in several of the countries surveyed. Conclusions The findings presented in this paper highlight the need to consider some factors in the discussion of the impact of public reporting in long-term care, namely, the organisation of care markets, frequently characterised by limited competition; the circumstances under which user choice takes place, often made under conditions of duress; and the leadership conditions needed to bring about improvements in quality in different care settings.

This paper describes and examines the schemes established in five EU countries for the recycling of packaging waste. The changes in packaging waste management were mainly implemented since the Directive 94/62/EC on packaging and packaging waste entered into force. The analysis of the five systems allowed the authors to identify very different approaches to cope with the same problem: meet the recovery and recycling targets imposed by EU law. Packaging waste is a responsibility of the industry. However, local governments are generally in charge of waste management, particularly in countries with Green Dot schemes or similar extended producer responsibility systems. This leads to the need of establishing a system of financial transfers between the industry and the local governments (particularly regarding the extra costs involved with selective collection and sorting). Using the same methodological approach, the authors also compare the costs and benefits of recycling from the perspective of local public authorities for France, Portugal and Romania. Since the purpose of the current paper is to take note of who is paying for the incremental costs of recycling and whether the industry (i.e. the consumer) is paying for the net financial costs of packaging waste management, environmental impacts are not included in the analysis. The work carried out in this paper highlights some aspects that are prone to be improved and raises several questions that will require further research. In the three countries analyzed more closely in this paper the industry is not paying the net financial cost of packaging waste management. In fact, if the savings attained by diverting packaging waste from other treatment (e.g. landfilling) and the public subsidies to the investment on the "recycling system" are not considered, it seems that the industry should increase the financial support to local authorities (by 125% in France, 50% in Portugal and 170% in Romania). However, in France and Portugal the industry is paying local authorities more than just the incremental costs of recycling (full costs of selective collection and sorting minus the avoided costs). To provide a more definitive judgment on the fairness of the systems it will be necessary to assess the cost efficiency of waste management operators (and judge whether operators are claiming costs or eliciting "prices").

This paper contributes to the debate on Europe's modern economic growth using the statistical concept of long-range dependence. Different regimes, defined as periods between two successive endogenously estimated structural shocks, matched episodes of pandemics and war. The most persistent shocks occurred at the time of the Black Death and the twentieth century's world wars. Our findings confirm that the Black Death often resulted in higher income levels but reject the view of a uniform long-term response to the Plague. In fact, we find a negative impact on incomes in non-Malthusian economies. In the North Sea Area (Britain and the Netherlands), the Plague was followed by positive trend growth in output per capita and population, heralding the onset of modern economic growth and the Great Divergence in Eurasia.

Global warming affects the distribution of stored product pest insects across Europe in a way comparable to field crop and orchard pests. Nevertheless, stored product research has been neglected in Europe and detailed monitoring is lacking. This paper aims to illustrate current knowledge about the movement of storage pests up north today triggered by altered environmental conditions. In addition, it stresses the need for a pan-European surveillance to monitor the distribution, movement and spreading of stored product pests in a rapidly changing environment. Global warming and a growing number of extreme weather conditions may influence on climate and can negatively affect global food security, especially in the case of durable commodities, which are of fundamental importance for human nutrition. It is thus suggested that the distribution of stored product pests within Europe is uniformly monitored and studied by a joint initiative. Furthermore, for additional food safety the World Food Program should receive more support to fund research needed and provide larger food storages in regions prone to agricultural instability. It is also suggested that the missing quarantine/regulated status for the most serious stored product and invasive pests (such as Trogoderma granarium) should be re-evaluated in the EU. info:eu-repo/semantics/acceptedVersion

Glavni dogodek, ki je Evropo prizadel poleti 2021, opominja družbo, da se poplave ponavljajo in so med najdražjimi in najsmrtonosnejšimi naravnimi nevarnostmi. Prizadevanja za dolgoročno obvladovanje poplavne ogroženosti (FRM), ki dajejo prednost izključno tehničnim ukrepom za preprečevanje in blažitev poplav, so se izkazala za premalo učinkovita in občutljiva za okolje. Nature-Based Solutions (NBS) označujejo nedavni premik paradigme FRM k rešitvam, ki uporabljajo lastnosti, procese in možnosti upravljanja, pridobljene iz narave, za izboljšanje zadrževanja vode in blažitev poplav. Vendar pa empirični dokazi o učinkih NBS v različnih okoljih ostajajo razdrobljeni in njihovo izvajanje se sooča z vrsto institucionalnih ovir. V tem prispevku smo sprejeli strokovno perspektivo skupnosti, ki temelji na naravnem zadrževanju poplav LAND4FLOOD na zasebnem omrežju zemljišč (https://www.land4flood.eu), da bi identificirali niz ovir ter njihove kaskadne in sestavljene interakcije, pomembne za posamezno NBS. Strokovnjaki so ugotovili obsežen nabor 17 ovir, ki vplivajo na izvajanje 12 skupin NBS v urbanih in podeželskih okoljih na petih evropskih regionalnih okoljskih območjih (t.j. borealno, atlantsko, celinsko, alpsko-karpatsko in sredozemsko). Na podlagi rezultatov opredeljujemo poti za nadaljnje raziskave, ki povezujejo hidrologijo in znanost tal na eni strani ter prostorsko načrtovanje, družbeno geografijo in ekonomijo na drugi strani. Naši predlogi nakazujejo transdisciplinaren preobrat v raziskavah NBS/FRM. The major event that hit Europe in summer 2021 reminds society that floods are recurrent and among the costliest and deadliest natural hazards. The long-term flood risk management (FRM) efforts preferring sole technical measures to prevent and mitigate floods have shown to be not sufficiently effective and sensitive to the environment. Nature-Based Solutions (NBS) mark a recent paradigm shift of FRM towards solutions that use nature-derived features, processes and management options to improve water retention and mitigate floods. Yet, the empirical evidence on the effects of NBS across various settings remains fragmented and their implementation faces a series of institutional barriers. In this paper, we adopt a community expert perspective drawing upon LAND4FLOOD Natural flood retention on private land network (https://www.land4flood.eu) in order to identify a set of barriers and their cascading and compound interactions relevant to individual NBS. The experts identified a comprehensive set of 17 barriers affecting the implementation of 12 groups of NBS in both urban and rural settings in five European regional environmental domains (i.e., Boreal, Atlantic, Continental, Alpine-Carpathian, and Mediterranean). Based on the results, we define avenues for further research, connecting hydrology and soil science, on the one hand, and land use planning, social geography and economics, on the other. Our suggestions ultimately call for a transdisciplinary turn in the research of NBS in FRM.

Anti-immigration attitudes and its origins have been investigated quite extensively. Research that focuses on the evolution of attitudes toward immigration, however, is far more scarce. In this paper, we use data from the first three rounds of the European Social Survey (ESS) to study the trend of anti-immigration attitudes between 2002 and 2007 in 17 European countries. In the first part of the paper, we discuss the critical legitimacy for comparing latent variable means over countries and time. A Multiple-Group Multiple Indicator Structural Equation Modeling (MGSEM) approach is used to test the cross-country and cross-time equivalence of the variables under study. In a second step, we try to offer an explanation for the observed trends using a dynamic version of group conflict theory. The country-specific evolutions in attitudes toward immigration are shown to coincide with national context factors, such as immigration flows and changes in unemployment rates.

Longevity expectations (LE) are subjective assessments of future health status that can influence a number of individual health protective decisions. This is especially true during a pandemic such as COVID-19, as the risk of ill health depends more than ever on such protective decisions. This paper examines the causal effect of LE on some protective health behaviors and a number of decisions regarding forgoing health care using individual differences in LE. We use data from the Survey of Health Ageing and Retirement in Europe, and we draw on an instrumental variable strategy exploiting individual level information on parental age at death. Consistent with the

Over the last 20 years, disaster events have been increasing with 3.25 billion people affected. The public are not only affected by these incidents but also, they are the first on the disaster scene. To fully utilize the public’s potential and define their role in assisting in disaster management, we need to hear the voice of the main responsible for handling a disaster, the authorities, and emergency personnel. Therefore, this paper aims to identify and prioritize their needs through conducting a survey and interviews with members of authorities and emergency organizations in several European Union countries, namely; France, Israel, Italy, Norway, Romania, Spain, and Sweden. The highest-ranked needs identified are getting credible information as soon as possible from the disaster scene as well as following authorities’ recommendations. Additionally, this study identifies some barriers associated with the engagement of society in disaster management. An example of such a barrier is that citizens could hurt themselves or others and hamper the intervention efforts through their interference. Despite the barriers, the emergency organizations are in favor of engaging the society in the response and recovery phases. The identified needs and barriers help to define procedures and policies that can improve the engagement of citizens and consequently, social resilience.

Harmful fisheries subsidies have historically contributed to fleet overcapacity and continue to be allocated to the fishing industry to artificially maintain its profitability. However, in this contribution we show that removing harmful subsidies and reducing overfishing will help to recover the resource biomass, subsequently leading to increased levels of sustainable catches, income and well-being of fishers, and reduces inequities in income and consumption when fish stocks are not effectively managed. Maintaining harmful fisheries subsidies is socially and economically inefficient. Taking the example of the EU fishing fleet, one of the largest fishing fleets in the world, we use the total factor productivity to show that small-scale fishing fleet's productivity is almost two-fold in the North Atlantic and 16% higher in the Mediterranean and Black seas compared to large-scale vessels. This result is explained because the harmful fisheries subsidies disproportionately allocated to large-scale vessels introduce distortions in the efficient allocation of inputs. With critical WTO negotiations ongoing regarding the global rules on fisheries subsidies, the EU must take advantage of the opportunity to lead a desirable transformative change while also supporting developing nations to truly achieve global sustainable and equitable fisheries This research is supported by the EQUALSEA (Transformative adaptation towards ocean equity) project, under the European Horizon 2020 Program, ERC Consolidator Grant Agreement no 101002784 funded by the European Research Council, and Grupo de Referencia Competitiva GI-2060 AEMI, under Grant ED431C2019/11. S.V thanks the Consellería de Educación da Xunta de Galicia (Galicia, Spain) for additional funding support. U.R.S. and D.J.S. thank the Pew Charitable Trusts and Oceana for their support of work related to harmful fisheries subsidies, and the OceanCanada Partnership supported by the Social Sciences and Humanities Research Council of Canada. The opinions expressed in this paper are those of the authors alone SI

Despite the global consensus about the growing significance of renewables, the regional drivers of innovation in these unique and novel technologies have been widely neglected in the literature. In this paper, we show that renewable energy (RE) inventions differ from other green inventions in the knowledge recombination processes leading to their generation as well as in their impact on subsequent inventions. The evidence on these specificities of RE technologies allows us hypothesizing that regional branching in renewables may rely on relatedness differently than other non-RE green technologies. In checking this hypothesis, we use a data set spanning the period 1981-2015 covering 277 European NUTS2 regions in the EU28 countries plus Norway. We obtain that relatedness is highly relevant in explaining regional specialization in RE, and more relevant than for other green technologies, which we associate to the lower generality in their impact and the narrower scope of the knowledge from which they nurture. This conclusion is maintained when considering separately regions with high and low development levels. However, the impact of relatedness increases for RE as the regional economic development decreases, signaling that a low endowment of resources and capabilities does not allow the region to break from its past technological specialization, depending more on relatedness. This would not be the case for other green technologies, probably due to their higher level of generality and wider scope.

Asia and Europe have made connectivity between people, businesses and institutions a top political priority in the frame of the Asia-Europe Meeting (ASEM) intergovernmental cooperation forum. In the ASEM context, policy leaders agreed that improving connectivity between countries should contribute to achieve the Sustainable Development Goals. Connectivity is a complex concept involving multiple dimensions. Yet in order to provide clear data-driven evidence to support policymaking on Asia-Europe sustainable connectivity, this concept calls for a measurement framework. The mismatch between the politically adopted definition of sustainable connectivity and existing metrics, led to the development of the two indexes described in this paper. Taken together, they help to explore and understand the relationship between connectivity and sustainability. The results suggest that connectivity and sustainability policy agendas have the potential to mutually reinforce one another. Higher values in connectivity are strongly associated with higher values in the social dimension of sustainability. There are evident gaps between European and Asian nations in terms of connectivity and sustainability. However, both continents are underpinned by the common challenge of reducing the environmental impacts of connectivity without neglecting economic/financial sustainability aspects, while at the same time ensuring that benefits will accrue to society at large.

The COST Action ‘European Raptor Biomonitoring Facility’ (ERBFacility) aims to develop pan-European raptor biomonitoring in support of better chemicals management in Europe, using raptors as sentinel species. This presents a significant challenge involving a range of constraints that must be identified and addressed. The aims of this study were to: (1) carry out a comprehensive review of the constraints that may limit the gathering in the field of raptor samples and contextual data, and assess their relative importance across Europe; and (2) identify and discuss possible solutions to the key constraints that were identified. We applied a participatory approach to identify constraints and to discuss feasible solutions. Thirty-one constraints were identified, which were divided into four categories: legal, methodological, spatial coverage, and skills constraints. To assess the importance of the constraints and their possible solutions, we collected information through scientific workshops and by distributing a questionnaire to stakeholders in all the countries involved in ERBFacility. We obtained 74 answers to the questionnaire, from 24 of the 39 COST participating countries. The most important constraints identified were related to the collection of complex contextual data about sources of contamination, and the low number of existing raptor population national/regional monitoring schemes and ecological studies that could provide raptor samples. Legal constraints, such as permits to allow the collection of invasive samples, and skills constraints, such as the lack of expertise to practice necropsies, were also highlighted. Here, we present solutions for all the constraints identified, thus suggesting the feasibility of establishing a long-term European Raptor Sampling Programme as a key element of the planned European Raptor Biomonitoring Facility., This paper is based on work from COST Action European Raptor Biomonitoring Facility (COST Action CA16224) supported by COST (European Cooperation in Science and Technology), including a grant for a short-term scientific mission awarded to the lead author. COST is funded by the Horizon 2020 Framework Programme of the European Union. Silvia Espín was financially supported by Ministerio de Ciencia, Innovación y Universidades (Juan de la Cierva-Incorporación postdoctoral contract, IJCI-2017-34653).

In Europe, regions in the Mediterranean area share common characteristics in terms of high sensitivity to climate change impacts. Does this translate into specificities regarding climate action that could arise from these Mediterranean characteristics? This paper sheds light on regional and local climate mitigation actions of the Mediterranean Europe, focusing on the plans to reduce greenhouse gases emissions in a representative sample of 51 regions and 73 cities across 9 Mediterranean countries (Croatia, Cyprus, France, Greece, Italy, Malta, Portugal, Slovenia, Spain). The study investigates: (i) the availability of local and regional mitigation plans, (ii) their goals in term of greenhouse gas emissions reduction targets on the short and medium-long term, and (iii) the impact of transnational climate networks on such local and regional climate mitigation planning. Results of this study indicate an uneven and fragmented planning, that shows a Mediterranean West-East divide, and a link with population size. However, overall, both regional and city action seem insufficiently ambitious with regards to meeting the Paris Agreement, at least at city level. While national frameworks are currently weak in influencing regional and local actions, transnational networks seem to be engaging factors for commitment (at city level) and ambitiousness (at regional level). The uneven and fragmented progress revealed by this study, does not align with the characteristics shared by investigated regions and cities in terms of environmental, socio-political, climatic and economic conditions. The results support the call of a common green deal at the Mediterranean level to further address specific Mediterranean challenges and related needs. This will allow to capitalise on available resources, generate local-specific knowledge, build capacities, and support Mediterranean regions and cities in preparing the next generation of more ambitious mitigation plans. info:eu-repo/semantics/publishedVersion