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Heart failure (HF) is a long‐term clinical syndrome, with increasing prevalence and considerable healthcare costs that are further expected to increase dramatically. Despite significant advances in therapy and prevention, mortality and morbidity remain high and quality of life poor. Epidemiological data, that is, prevalence, incidence, mortality, and morbidity, show geographical variations across the European countries, depending on differences in aetiology, clinical characteristics, and treatment. However, data on the prevalence of the disease are scarce, as are those on quality of life. For these reasons, the ESC‐HFA has developed a position paper to comprehensively assess our understanding of the burden of HF in Europe, in order to guide future policies for this syndrome. This manuscript will discuss the available epidemiological data on HF prevalence, outcomes, and human costs—in terms of quality of life—in European countries. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To investigate the methods and results used and conclusions found in available published papers on childhood overweight and obesity in Europe. SURVEYS:: This paper compares the two available published papers on the prevalence of child and adolescent overweight and obesity in Europe. The first paper was published in November 2003 and was based on 20 previously conducted surveys performed from 1992 to 2001. The other paper was published in January 2004 and was based on data from the WHO collaborative survey‘Health Behaviour in School Children’, which collected the data in 1997-1998 within a period of 9 months. Height and weight were included as optional questions and 13 European countries, Israel and United States participated. METHODS:: In both papers, body mass index (BMI) was used. In the first paper, measured BMI was used and prevalence of overweight was calculated using IOTF cutoff points. In the other paper, overweight and obesity prevalences were calculated from self-reported height and weight using an internal study reference standard. RESULTS:: The first paper found a north-south trend in overweight in Europe, whereas the second found a more equal distribution of overweight in European children. Thus, overweight was significantly increased among 13?y olds of both sexes in Finland, Ireland, and Greece, and in Portuguese girls. Among 15?y olds, the prevalence of overweight was significantly increased in Greek boys, and in Danish and Portuguese girls. On the contrary, in Lithuania, there was a significantly low prevalence of overweight among both ages and both sexes. CONCLUSION:: Critical reviews of the results of the two published papers show that the year of data collection, methods and use of appropriate statistics are of critical importance for the conclusion drawn from comparative epidemiological surveys on the prevalence of overweight.International Journal of Obesity (2004) 28, S10-S15. doi:10.1038/sj.ijo.0802822 [ABSTRACT FROM AUTHOR]

This review gives an update on recent epidemiologic data on periodontal diseases and a description of current periodontal services in Europe. A Medline search of articles published within the last decade with the keywords epidemiology, prevalence, periodontitis, tooth loss, and Europe was performed. Data on provision of dental services originated from international databases. Epidemiologic data on the prevalence of edentulism, the number of missing teeth, the prevalence of probing depth (Community Periodontal Index – CPI ≥ 3 or Pocket Depth – PD ≥ 4 mm), and clinical attachment loss (CAL ≥ 4 mm) displayed a fragmentary picture within Europe. With respect to the limited data on periodontal health, Spain, Sweden, and Switzerland ranked as the healthiest among European countries in contrast to Germany where increased tooth loss and the highest prevalence of CAL ≥ 4 mm were reported. The role of dental auxiliaries especially of dental hygienists and/or the medico-legal framework in which they work, appears to be an important factor in provision of effective periodontal care. Actual epidemiologic data on periodontal diseases are non-homogeneous and absent from several European countries. This emphasises the need for more national representative epidemiological studies with a uniform design to permit comparability between different nations. Merging actual epidemiologic data with former data on provision of periodontal care may help to explain differences in periodontal parameters on a population basis and to define future provision of dental care. [ABSTRACT FROM AUTHOR]

Deer are susceptible to infection with parasitic helminths, including species which are of increasing economic concern to the livestock industry due to anthelmintic drug resistance. This paper systematically collates helminth prevalence data from deer across Europe and explores patterns in relation to host and parasite species, as well as landscape factors. A livestock pasture contact index (LPCI) is developed to predict epidemiological overlap between deer and livestock, and hence to examine deer helminth fauna in the context of their surrounding environment. Fifty-eight studies comprising fallow (Dama dama), red (Cervus elaphus), roe (Capreolus capreolus) and sika (Cervus nippon) deer were identified. Deer populations in "likely" contact with livestock pasture had a higher mean prevalence of the abomasal nematodes Haemonchus contortus, Ostertagia ostertagi, Teladorsagia circumcincta and Trichostrongylus axei (p = 0.01), which are common in livestock and not primarily associated with deer. Roe deer populations had a higher prevalence of T. circumcincta (p = 0.02) and T. axei (p = 0.01) than fallow deer and a higher prevalence of H. contortus than both red (p = 0.01) and fallow deer (p = 0.02). Liver fluke and lungworm species were present sporadically at low prevalence, while the abomasal nematode Ashworthius sidemi occurred locally at high prevalence. Insights from this research suggest that deer helminth fauna is reflective of their surrounding environment, including the livestock species which inhabit areas of shared grazing. This is explored from an epidemiological perspective, and the prospect of helminth transmission between wild and domestic hosts is discussed, including drug-resistant strains, alongside the role of helminths as indicators relevant to the transmission of other pathogens at the wildlife–livestock interface. [ABSTRACT FROM AUTHOR]

Paralleling the global epidemic of obesity figures in the general population, the incidence of maternal obesity (BMI>30kg/m(2) at the start of pregnancy) has been rising over the last world. While most European countries do not systematically report obesity figures in their pregnant population, the prevalence of maternal obesity varies from 7 to 25% and seems strongly related to social and educational inequalities. Obesity during pregnancy represents an important preventable risk factor for adverse pregnancy outcomes and is associated with negative long-term health outcomes for both mothers and offspring. These effects are often aggravated by the high incidence of abnormal glucose tolerance and excessive gestational weight gain found in this group. The main controversies around the management of the obese pregnant women are related to (1) the value of repeated weighing during pregnancy, (2) the optimal gestational weight gain to advise and the lifestyle messages to deliver in order to achieve this, (3) the optimal strategy and timing of screening for gestational diabetes (GDM) and (4) the optimal timing and mode of delivery. These controversies are reviewed in this review, with the exception of screening for gestational diabetes that is discussed extensively elsewhere in this issue (Benhalima et al.). An agenda for research is proposed with the hope that it will catch the attention of policy-makers and funders and ultimately lead to the development of European-wide evidence-based guidelines for clinicians. [ABSTRACT FROM AUTHOR]

The top 100 most cited papers in social work journals in 2000–09 were recently listed in a British Journal of Social Work paper by Hodge, Lacasse and Benson. The citations of these 100 papers in a two-year period (2007–09) were identified and a further manual web-based search was conducted to identify some key features of the citing sources. Descriptive statistics are presented on language of publication and national location of citing authors, as well as type of citing source. Bivariate analysis was conducted of the national location of cited journal by national location of citing first author. This analysis shows a strong tendency towards within-country citation in both the UK and USA, providing some evidence of intellectual chauvinism amongst social work academics and, more specifically, evidence of a Great Atlantic Divide. [ABSTRACT FROM PUBLISHER]

Working-age households where no-one is in work have become an increasing focus of policy concern even before the economic crisis, and the European Union (EU) has included household joblessness in its new poverty reduction target for 2020. This paper focuses on the variation across EU countries in the prevalence of household joblessness and its impact on income poverty and deprivation, and on the implications for the new EU poverty reduction target. It highlights first that there are some divergences across key data sources in the extent of joblessness. The prevalence of household joblessness varies substantially across EU countries, but there is little evidence of a consistent pattern among groupings of countries often categorized together in terms of welfare regime or geographically. In aggregate there is little association between the overall extent of household joblessness in a country and the percentage in relative income poverty or above a material deprivation threshold. At a micro level, being in a jobless household has a substantial impact on the likelihood of being in relative income poverty or deprived, but the scale of these impacts is shown to be very much greater in some countries than in others, and to vary between single-adult and multiple-adult households. In most EU countries little more than half the working-age adults in jobless households are either income-poor or deprived, so including joblessness in the poverty reduction target does make a difference, without a clearly articulated rationale. [ABSTRACT FROM PUBLISHER]

Background: Neisseria meningitidis is an encapsulated Gram-negative diplococcus that asymptomatically colonises the upper respiratory tract in up to 25% of the population (mainly adolescents and young adults). Invasive meningococcal disease (IMD) caused by Neisseria meningitidis imposes a substantial public health burden,. The case fatality rate (CFR) of IMD remains high. IMD epidemiology varies markedly by region and over time, and there appears to be a shift in the epidemiology towards older adults. The objective of our review was to assess the published data on the epidemiology of IMD in older adults (those aged ≥ 55 years)in North America and Europe. Such information would assist decision-makers at national and international levels in developing future public health programmes for managing IMD.Methods: A comprehensive literature review was undertaken on 11 August 2020 across three databases: EMBASE, Medline and BIOSIS. Papers were included if they met the following criteria: full paper written in the English language; included patients aged ≥ 56 years; were published between 1/1/2009 11/9/2020 and included patients with either suspected or confirmed IMD or infection with N. meningitidis in North America or Europe. Case studies/reports/series were eligible for inclusion if they included persons in the age range of interest. Animal studies and letters to editors were excluded. In addition, the websites of international and national organisations and societies were also checked for relevant information.Results: There were 5,364 citations identified in total, of which 76 publications were included in this review. We identified that older adults with IMD were mainly affected by serogroups W and Y, which are generally not the predominant strains in circulation in most countries. Older adults had the highest CFRs, probably linked to underlying comorbidities and more atypical presentations hindering appropriate timely management. In addition, there was some evidence of a shift in the incidence of IMD from younger to older adults.Conclusions: The use of meningococcal vaccines that include coverage against serogroups W and Y in immunization programs for older adults needs to be evaluated to inform health authorities' decisions of the relative benefits of vaccination and the utility of expanding national immunization programmes to this age group. [ABSTRACT FROM AUTHOR]

Production from crops of pome, stone fruit, nut, berry fruit, citrus, grapevine, and olive is increasingly threatened by fungal trunk diseases (FTD). These diseases and the consequent production losses are major problems. Many fungi (including Botryosphaeriaceae, Calosphaeriaceae, Diaporthaceae, Diatrypaceae, Nectriaceae, Phaeomoniellaceae, Pleosporaceae, Togniniaceae, Valsaceae) infect host wood, mainly through wounds and subsequent colonization of woody tissues, causing symptoms such as cankers, gummosis, wood rotting, blight and dieback. Propagative plant material, seedlings and fruit play a significant role in pathogen spread. Several abiotic factors (e.g. shifts in cultural practices and climate change) are involved in the disease development. This paper reviews recent literature on FTD of fruit crops, particularly focusing on the European status of pathogen occurrence. Case studies are described related to diseases of apple, citrus, grapevine, berry, nut and stone fruit, and olive trees. Aspects related to epidemiology and the increase in disease incidence along with the future perspectives on the FTD research are also discussed. [ABSTRACT FROM AUTHOR]

COVID-19 represents the greatest health crisis in recent human history. To date, it is still difficult to estimate its impact on mortality. This paper investigates the excess crude mortality in 27 European countries. The differences between the values observed in 2020 and 2021 with those predicted by a joinpoint regression model were evaluated. A multi-regression analysis was implemented to assess the relationship between health variables and excess mortality. Europe experienced a marked and surprising (S-value > 52) increase in crude mortality during 2020 (Δ% = +10.0%, 95% CI: [2.5; 18.7]) and 2021 (Δ% = +12.1%, 95% CI: [4.3; 21.2]). The difference between average excesses of Eastern and Western countries was not surprising (S < 2) and had little relevance (ΔE-W = −2.4, 95% CI: [−2; 7]) during 2020 but was more pronounced (S = 15, ΔE-W = +17.2, 95% CI: [11.0; 23.5]) during 2021. Excess crude mortality increased in 2021 (Δ% = +65%, 95% CI: [12.6; 118], S = 5.9). Evidence has been found for a surprising and marked negative linear relationship between COVID-19 vaccinations and excess mortality ("2021 excess mortality = A + BX4", with "A = 58 ± 7, S = 28" and "B = −0.65 ± 0.10, S = 22, Radj2 = 0.65, 95% CI: [0.38; 0.82]). In light of the current literature, these findings provide solid evidence of the substantial role of COVID-19 in the unexpected and marked excess mortality recorded in Europe. COVID-19 vaccinations have appeared to be one of the main determinants for reducing mortality. Future research should explore these aspects in more detail. [ABSTRACT FROM AUTHOR]

In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published the first systematic review that summarized the prevalence of food allergy (FA) and food sensitization in Europe for studies published 2000–2012. However, only summary estimates for tree nut allergy (TNA) were feasible in that work. In the current update of that systematic review, we summarized the prevalence of tree nut allergy/sensitization to individual tree nuts. Six databases were searched for relevant papers published 2012–2021 and 17 eligible studies were added to the 15 studies already identified between 2000 and 2012, giving a total of 32 studies. Of the investigated tree nuts, meta‐analysis was possible for hazelnut, walnut, almond, and in few cases, for cashew, and Brazil nut. The lifetime self‐reported prevalence was 0.8% (95% CI 0.5–1.1) for hazelnut and 0.4% (0.2–0.9) for walnut. The point self‐reported prevalence was 4.0% (2.9–5.2) for hazelnut, 3.4% (2.0–4.9) for Brazil nut, 2.0% (1.1–2.9) for almond, and 1.8% (1.1–2.5) for walnut. Point prevalence of food challenge‐confirmed TNA was 0.04% (0.0–0.1) for hazelnut and 0.02% (0.01–0.1) for walnut. Due to paucity of data, we could not identify any meaningful and consistent differences across age groups and European regions. [ABSTRACT FROM AUTHOR]

Analysis of phylogenetic trees has become an essential tool in epidemiology. Likelihood-based methods fit models to phylogenies to draw inferences about the phylodynamics and history of viral transmission. However, these methods are often computationally expensive, which limits the complexity and realism of phylodynamic models and makes them ill-suited for informing policy decisions in real-time during rapidly developing outbreaks. Likelihood-free methods using deep learning are pushing the boundaries of inference beyond these constraints. In this paper, we extend, compare, and contrast a recently developed deep learning method for likelihood-free inference from trees. We trained multiple deep neural networks using phylogenies from simulated outbreaks that spread among 5 locations and found they achieve close to the same levels of accuracy as Bayesian inference under the true simulation model. We compared robustness to model misspecification of a trained neural network to that of a Bayesian method. We found that both models had comparable performance, converging on similar biases. We also implemented a method of uncertainty quantification called conformalized quantile regression that we demonstrate has similar patterns of sensitivity to model misspecification as Bayesian highest posterior density (HPD) and greatly overlap with HPDs, but have lower precision (more conservative). Finally, we trained and tested a neural network against phylogeographic data from a recent study of the SARS-Cov-2 pandemic in Europe and obtained similar estimates of region-specific epidemiological parameters and the location of the common ancestor in Europe. Along with being as accurate and robust as likelihood-based methods, our trained neural networks are on average over 3 orders of magnitude faster after training. Our results support the notion that neural networks can be trained with simulated data to accurately mimic the good and bad statistical properties of the likelihood functions of generative phylogenetic models. [ABSTRACT FROM AUTHOR]

Background: Migrant populations from countries with generalised HIV epidemics make up a significant proportion of all HIV/AIDS cases in many European Union and European Economic Area (EU/EEA) countries, with heterosexual transmission the predominant mode of HIV acquisition. While most of these infections are diagnosed for the first time in Europe, acquisition is believed to have predominantly occurred in the home country. A proportion of HIV transmission is believed to be occurring post-migration, and many countries may underestimate the degree to which this is occurring. Our objectives were to review the literature estimating the proportion of migrants believed to have acquired their HIV post-migration and examine which EU member states are able to provide estimates of probable country of HIV acquisition through current surveillance systems. Methods: A systematic review was undertaken to gather evidence of sexual transmission of HIV within Europe among populations from countries with a generalised epidemic. In addition, national surveillance focal points from 30 EU/EEA Member States were asked to complete a questionnaire about surveillance methods and monitoring of the likely place of HIV acquisition among migrants. Results & discussion: Twenty-seven papers from seven countries were included in the review and 24 countries responded to the survey. Estimates of HIV acquisition post-migration ranged from as low as 2 % among sub Saharan Africans in Switzerland, to 62 % among black Caribbean men who have sex with men (MSM) in the UK. Surveillance methods for monitoring post-migration acquisition varied across the region; a range of methods are used to estimate country or region of HIV acquisition, including behavioural and clinical markers. There is little published evidence addressing this issue, although Member States highlight the importance of migrant populations in their epidemics. Conclusions: There is post-migration HIV acquisition among migrants in European countries but this is difficult to quantify accurately with current data. Migrant MSM appear at particular risk of HIV acquisition post-migration. Countries that identify migrants as an important part of their HIV epidemic should focus on using an objective method for assigning probable country of HIV acquisition. Robust methods to measure HIV incidence should be considered in order to inform national prevention programming and resource allocation. [ABSTRACT FROM AUTHOR]

The number of outlaw bikers is growing globally. Despite this, little research exists on these groups and their alleged violent tendencies. To address this, the current paper uses unique data to examine whether gang violence causes outlaw biker violence. The period examined runs from mid-2008 until early 2012 during which violent clashes occurred between outlaw bikers and street gang members involved in an alleged conflict in Copenhagen, Denmark. A precise description of each individual act of violence would make it possible to identify whether specific acts were carried out in furtherance of the alleged conflict. This would allow one to determine whether outlaw bikers commit violence on behalf of their club. However, such knowledge is unavailable. The paper therefore takes a different approach by examining whether acts of violence committed by the two groups are statistically associated. In other words, it considers whether one or more acts can be described as retaliatory during the observation periods. The sample consists of 640 individuals involved with the Hells Angels Motorcycle Club or with non-biker street gangs–both of which are present in Copenhagen. Statistical models are used to predict 143 violent events committed by 196 outlaw bikers. The results suggest that violence committed by gang members predicts violence committed by outlaw bikers. This indicates that violent acts committed by outlaw bikers are at least partly a form of retaliation carried out on behalf of their club. The paper expands the literature on the kinds of inter-group, micro-level processes that can lead to reciprocal violence by including outlaw bikers in a literature that has previously focused on non-biker street gangs. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency (25-hydroxyvitamin D; 25(OH)D) is at epidemic proportions in western dwelling South Asian populations, including severe deficiency (<12⋅5 nmol/l) in 27-60% of individuals, depending on season. The paper aimed to review the literature concerning vitamin D concentrations in this population group. Research from the UK and Europe suggests a high prevalence of South Asians with 25(OH)D concentration <25 nmol/l, with most having a 25(OH)D concentration of <50 nmol/l. In Canada, South Asians appear to have a slightly higher 25(OH)D concentration. There are few studies from the United States, South Africa and Australasia. Reasons for vitamin D deficiency include low vitamin D intake, relatively high adiposity, sun exposure avoidance and wearing of a covered dress style for cultural reasons. Possible health effects of deficiency include bone diseases such as rickets and hypocalcaemia in children and osteomalacia in adults. Vitamin D deficiency may also increase the risk of other chronic diseases. Increased fortification of food items relevant to South Asian groups (e.g. chapatti flour), as well as increased use of vitamin D supplements may help reduce this epidemic. Introducing culturally acceptable ways of increasing skin exposure to the sun in South Asian women may also be beneficial but further research is needed to assess the effectiveness of different approaches. There may be a need for a South Asian specific vitamin D dietary intake guideline in western countries. To conclude, vitamin D deficiency is epidemic in South Asians living in western countries and there is a clear need for urgent public health action. [ABSTRACT FROM AUTHOR]

Aims: Progress towards meeting the goal of measles elimination in the EU and the European Economic Area (EEA) by 2015 is being obstructed, as some children are either not immunized on time or never immunized. One group thought to be at increased risk of measles is migrants; however, the extent to which this is the case is poorly understood, due to a lack of data. This paper addresses this evidence gap by providing an overview of the burden of measles in migrant populations in the EU/EEA. Methods: Data were collected through a comprehensive literature review, a country survey of EU/EEA member states and information from measles experts gathered at an infectious disease workshop. Results: Our results showed incomplete data on measles in migrant populations, as national surveillance systems do not systematically record migration-specific information; however, evidence from the literature review and country survey suggested that some measles outbreaks in the EU/EEA were due to sub-optimal vaccination coverage in migrant populations. Conclusions: We conclude that it is essential that routine surveillance of measles cases and measles, mumps and rubella (MMR) vaccination coverage become strengthened, to capture migrant-specific data. These data can help to inform the provision of preventive services, which may need to reach out to vulnerable migrant populations that currently face barriers in accessing routine immunization and health services. [ABSTRACT FROM AUTHOR]

The present review was aimed to describe the prevalence and the regional distribution of malocclusion among preschool children worldwide. Two independent reviewers performed a systematic literature search to identify English publications from January 2010 to May 2024 using PubMed, ISI Web of Science and Embase. Search MeSH key words were "malocclusion", "primary dentition" and "child, preschool". The reporting quality was assessed by the modified Newcastle–Ottawa Quality Assessment Scale. We identified 2599 publications and recruited 47 articles. Fourteen of the included studies were conducted in Asia, four in Europe, twenty-eight in South America and one in Africa. The prevalence of malocclusion ranged from 28.4% to 83.9%, and half of the reported prevalences were higher than 50%. The highest percentage was in Asia (61.81%), followed by Europe (61.50%), South America (52.69%) and Africa (32.50%). Statistically significant differences existed in deep overbite, anterior open bite, posterior crossbite, edge-to-edge incisor relationship and distal step between continents (p < 0.05). Europe showed the highest prevalence (33.08%) of deep overbite. Africa showed the highest prevalence (18.60%) of anterior open bite. Europe showed the highest prevalence (15.38%) of posterior crossbite. The most common malocclusion traits were increased overjet and deep overbite. To conclude, malocclusion remained prevalent in the primary dentition and varied between countries. [ABSTRACT FROM AUTHOR]

Ecoregionalization is the process by which a territory is classified in similar areas according to specific environmental and climatic factors. The climate and the environment strongly influence the presence and distribution of vectors responsible for significant human and animal diseases worldwide. In this paper, we developed a map of the eco-climatic regions of Italy adopting a data-driven spatial clustering approach using recent and detailed spatial data on climatic and environmental factors. We selected seven variables, relevant for a broad set of human and animal vector-borne diseases (VBDs): standard deviation of altitude, mean daytime land surface temperature, mean amplitude and peak timing of the annual cycle of land surface temperature, mean and amplitude of the annual cycle of greenness value, and daily mean amount of rainfall. Principal Component Analysis followed by multivariate geographic clustering using the k-medoids technique were used to group the pixels with similar characteristics into different ecoregions, and at different spatial resolutions (250 m, 1 km and 2 km). We showed that the spatial structure of ecoregions is generally maintained at different spatial resolutions and we compared the resulting ecoregion maps with two datasets related to Bluetongue vectors and West Nile Disease (WND) outbreaks in Italy. The known characteristics of Culicoides imicola habitat were well captured by 2/22 specific ecoregions (at 250 m resolution). Culicoides obsoletus/scoticus occupy all sampled ecoregions, according to its known widespread distribution across the peninsula. WND outbreak locations strongly cluster in 4/22 ecoregions, dominated by human influenced landscape, with intense cultivations and complex irrigation network. This approach could be a supportive tool in case of VBDs, defining pixel-based areas that are conducive environment for VBD spread, indicating where surveillance and prevention measures could be prioritized in Italy. Also, ecoregions suitable to specific VBDs vectors could inform entomological surveillance strategies. [ABSTRACT FROM AUTHOR]

Objectives: This paper focuses on the issue of intimate partner violence and, specifically, on the distribution of femicides over time and the existence of copycat effects. This is the subject of an ongoing debate often triggered by the social alarm following multiple intimate partner homicides (IPHs) occurring in a short span of time. The aim of this research is to study the evolution of IPHs and provide a far-reaching answer by rigorously analyzing and searching for patterns in data on femicides. Methods: The study analyzes an official dataset, provided by the system VioGén of the Secretaría de Estado de Seguridad (Spanish State Secretariat for Security), including all the femicides occurred in Spain in 2007-2017. A statistical methodology to identify temporal interdependencies in count time series is proposed and applied to the dataset. The same methodology can be applied to other contexts. Results: There has been a decreasing trend in the number of femicides per year. No interdependencies among the temporal distribution of femicides are observed. Therefore, according to data, the existence of copycat effect in femicides cannot be claimed. Conclusions: Around 2011 there was a clear change in the average number of femicides which has not picked up. Results allow for an informed answer to the debate on copycat effect in Spanish femicides. The planning of femicides prevention activities should not be a reaction to a perceived increase in their occurrence. As a copycat effect is not detected in the studied time period, there is no evidence supporting the need to censor media reports on femicides. [ABSTRACT FROM AUTHOR]

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This paper develops the first survival analysis of a large-scale mortality crisis caused by plague. For the time-to-event analyses we used the Cox proportional hazards regression model. Our case study is the town of Nonantola during the 1630 plague, which was probably the worst to affect Italy since the Black Death. Individual risk of death did not depend on sex, grew with age (peaking at ages 40-60 and then declining), was not affected by socio-economic status, and was positively associated with household size. We discuss these findings in light of the historical-demographic and palaeo-demographic literature on medieval and early modern plagues. Our results are compatible with the debated idea that ancient plague was able to spread directly from human to human. Our methods could be replicated in other studies of European plagues to nuance and integrate the findings of recent palaeo-biological and palaeo-demographic research on plague. [ABSTRACT FROM AUTHOR]

This paper demonstrates that the susceptible-infected-removed (SIR) model applied to the early phase of an epidemic can be used to determine epidemic parameters reliably. As a case study, the SIR model is applied to the fatality data of the 2009 fall wave cycle of the A(H1N1) pandemic in 12 European countries. It is observed that the best estimates of the basic reproduction number and the mean duration of the infection period lie on a curve in the scatterplots, indicating the existence of a nearly-invariant quantity which corresponds to the duration of the epidemic. Spline interpolation applied to the early phase of the epidemic, an approximately 10-week period, together with a future control point in the stabilization region, is sufficient to estimate model parameters. The SIR model is run over a wide range of parameters and estimates of in the range 1.2-2.0 match the values in the literature. The duration of the infection period, is estimated to be in the range 2.0-7.0 days. Longer infection periods are tied to spatial characteristics of the spread of the epidemic. [ABSTRACT FROM AUTHOR]

The relationship between cannabis and psychosis and schizophrenia has tested the field of addiction for decades, and in some ways serves as measure of our ability to provide a credible contribution to public health. As cannabis is used widely, many people are interested in the risks the drug poses to mental health. This paper focuses upon a seminal study examining this, the trajectory of subsequent research findings and what this has meant for understanding and communicating risk factor information. These studies provided evidence of a dose-response relationship between cannabis and psychosis, and that for those individuals with schizophrenia cannabis exacerbated their symptoms. The findings fit with a multi-causal model in which vulnerability interacts with a precipitating agent to produce a disease outcome. Even though this is a common model in epidemiology, it has proved difficult to communicate it in this case. This may be because at a population level the increased risk is weak and the vulnerabilities relatively rare. It may also be because people bring strongly held preconceptions to interpreting a complex multi-causal phenomenon. [ABSTRACT FROM AUTHOR]

Background This article of the International Epidemiological Association commissioned paper series stocktakes the population health and status of epidemiology in 21 of the 53 countries of the WHO European Region. By United Nations geographical classification, these countries belong to Eastern Europe, Western Asia and South-Central Asia.Methods Published data were used to describe population health indicators and risk factors. Epidemiological training and research was assessed based on author knowledge, information searches and E-mail survey of experts. Bibliometric analyses determined epidemiological publication outputs.Results Between-country differences in life expectancy, amount and profile of disease burden and prevalence of risk factors are marked. Epidemiological training is affected by ongoing structural reforms of educational systems. Training is advanced in Israel and several Eastern European countries. Epidemiological research is mainly university-based in most countries, but predominantly conducted by governmental research institutes in several countries of the former Soviet Union. Funding is generally external and limited, partially due to competition from and prioritization of biomedical research. Multiple relevant professional societies exist, especially in Poland, the Czech Republic and Hungary. Few of the region’s 39 epidemiological academic journals have international currency. The number of epidemiological publications per population is highest for Israel and lowest for South-Central Asian countries.Conclusions Epidemiological capacity will continue to be heterogeneous across the region and depend more on countries’ individual historical, social, political and economic conditions and contexts than their epidemiologists’ successive efforts. National and international research funding, and within- and between-country collaborations should be enhanced, especially for South-Central Asian countries. [ABSTRACT FROM AUTHOR]

Plant food supplements (PFS) receive great acceptance by European consumers. However, quality and efficacy of these products remain a question of concern. The aim of this systematic review is to summarize and critically evaluate the evidence for or against the efficacy of PFS for coping inflammatory conditions by considering epidemiological and human intervention studies. The review, which consists of two parts, considersOlea europeaL.,Camellia sinensisL.,Vitis viniferaL., andMatricaria recutitaL., which are herbal material frequently used also as food. The search retrieved 1251 publications. By applying the inclusion/exclusion criteria, the final number of papers was 91.Vitis viniferaL. showed promising results, but other trials should be performed in order to assessing the efficacy. Surprisingly, it was impossible to draw conclusions for the anti-inflammatory effect ofCamellia sinensisL. as green tea. No studies were found on the leaves ofOlea europeaL. whereas more human trials are needed to assess the anti-inflammatory effect of olive oil. Only one study forMatricaria recutitaL. was selected. In conclusion, it is advisable to conduct further studies with more homogeneous population and larger number of subjects by avoiding the heterogeneity of the herbal preparations considered. [ABSTRACT FROM PUBLISHER]

The adverse effects of noise on health have been intensely explored in the past 50 years. However, the scope of research conducted in the Central and Eastern Europe, South-East Europe, and Newly Independent States is not well-known. The aim of this review was to present studies on cardiovascular effects of environmental noise in adults published since 1965 and to point out the most important issues that need to be addressed in the future. More than 100 papers on noise and health and about 20 papers on cardiovascular effects of environmental noise in adults were identified by literature search. The authors reviewed scientific international and local journals, conference proceedings, and local reports published in national languages. The major endpoints were high blood pressure, ischemic heart disease, and myocardial infarction. The target populations were adults. Experimental and exposure-assessment studies, field, empirical studies, social surveys, and epidemiological studies are presented. The major sources of environmental noise were road and air traffic. The results were presented in tables and the most relevant articles were briefly discussed. The importance of this review is that it refers to some countries that no longer exist in the same political and governmental systems. The strength of this paper is that it includes publications that were not evaluated in earlier systematic reviews. Strategies for future noise-related research on national and global level are proposed. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the level of awareness of prostate cancer (PCa) among the general public and PCa patients in Europe and North America. A survey was undertaken across four European countries (UK, Germany, Italy and Spain), and across the United States and Canada in late 2007. In total, 1008 men with PCa and their partners (the ‘prostate sample’), and 911 men without PCa and their partners (the ‘well sample’) participated in the survey, all aged 50 years. Interviews were conducted through telephone, pen and paper, and online. Many people surveyed (53%) thought that breast cancer is more common than PCa. Moreover, 1 in 10 people from the well sample (10%) thought that PCa affects both men and women. When the prostate sample was asked about their perceived level of risk of PCa before diagnosis, 50% believed that they/their husband or partner were previously at low or very low risk, before they were diagnosed. Awareness of the major risk factors for PCa (age and family history) was generally good, but respondents were less clear about the role of other potential factors, such as smoking and drinking alcohol. This international survey, thought to be largest of its type, shows that although patient and public awareness of PCa is generally satisfactory, there is still a considerable lack of clarity about PCa risk factors, and a danger for people to underestimate their own/their partner's perceived risk for PCa. Programmes to responsibly educate and inform men and their partners about risk factors, prevalence and screening tools for PCa are required. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: The 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so‐called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade. Methods: Six databases were searched for studies published 2012–2021. Random‐effects meta‐analysis was performed to derive pooled prevalence of allergy to each food. Results: Twenty‐seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self‐reported kiwi allergy was 0.1%–1.0% and 0.2%–8.1%, respectively, while the food challenge (FC)‐verified kiwi allergy point prevalence range was 0.01%–0.10%. The point prevalence range for self‐reported peach allergy was 0.2%–3.2%, while the range for FC‐verified peach allergy was 0.02%–0.05%. The lifetime and point prevalence range for self‐reported tomato allergy was 0.01%–1.8% and 0.2%–2.1%, respectively. Conclusion: Allergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so‐called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment. [ABSTRACT FROM AUTHOR]

Hip fracture constitutes a significant health concern especially for older adults. The incidence of hip fractures varies among countries, but it is estimated that globally, around 18% of women and 6% of men will be affected. Despite a gradual decrease in age-standardized incidence in several countries, the overall increase in the ageing population will lead to an expected rise in the number of hip fractures. This review provides an overview of hip fractures in European countries focuses on the most recent epidemiological data on hip fracture. [ABSTRACT FROM AUTHOR]

INTRODUCTION The Tobacco Control Scale (TCS) was designed for advocacy purposes but has also been used as a research tool. In the present study, we characterized TCS use, its limitations and strengths, and critically assessed its use as a research instrument. METHODS We conducted an extensive search of the biomedical databases PubMed and Web of Science for the keyword 'tobacco control scale' in all fields. The search was limited to studies published in the period March 2006 to December 2019. Out of 69 hits, 32 studies met the inclusion criteria. Two reviewers independently extracted information from each publication regarding their general characteristics, publication and research aspects, and the characteristics of the use of the TCS. RESULTS We found that researchers have used the TCS as a tool to monitor tobacco control policies mainly in cross-sectional observational studies with ecological and multilevel designs directed to advocacy and the promotion of further research. Different outcomes, such as smoking prevalence and quit ratios, have been associated with tobacco control policy scores. The main reported limitations of the TCS were a low variance across countries and a failure to express enforcement and to incorporate the most recent legislation. CONCLUSIONS The TCS has been commonly used to assess differences in outcomes according to tobacco control policies. However, there are still areas for improvement in its use in research regarding the lack of comparability of TCS scores across time. The lessons that have been learned should be used to adapt and expand the TCS overseas. [ABSTRACT FROM AUTHOR]

In preparation of a large European epidemiological study on the relation between eye lens dose and the occurrence of lens opacities, the European ELDO project focused on the development of practical methods to estimate retrospectively cumulative eye lens dose for interventional medical professionals exposed to radiation. The present paper applies one of the ELDO approaches, correlating eye lens dose to whole-body doses, to assess cumulative eye lens dose for 14 different Finnish interventional cardiologists for whom annual whole-body dose records were available for their entire working period. The estimated cumulative left and right eye lens dose ranged from 8 to 264 mSv and 6 to 225 mSv, respectively. In addition, calculations showed annual eye lens doses sometimes exceeding the new ICRP annual limit of 20 mSv. The work also highlights the large uncertainties associated with the application of such an approach proving the need for dedicated dosimetry systems in the routine monitoring of the eye lens dose. [ABSTRACT FROM AUTHOR]

Noise prediction models and noise maps are used to estimate the exposure to road traffic noise, but their availability and the quality of the noise estimates is sometimes limited. This paper explores the application of land use regression (LUR) modelling to assess the long-term intraurban spatial variability of road traffic noise in three European cities. Short-term measurements of road traffic noise taken in Basel, Switzerland (n=60), Girona, Spain (n=40), and Grenoble, France (n=41), were used to develop two LUR models: (a) a 'GIS-only' model, which considered only predictor variables derived with Geographic Information Systems; and (b) a 'Best' model, which in addition considered the variables collected while visiting the measurement sites. Both noise measurements and noise estimates from LUR models were compared with noise estimates from standard noise models developed for each city by the local authorities. Model performance (adjusted R2) was 0.66-0.87 for 'GIS-only' models, and 0.70-0.89 for 'Best' models. Short-term noise measurements showed a high correlation (r=0.62-0.78) with noise estimates from the standard noise models. LUR noise estimates did not show any systematic differences in the spatial patterns when compared with those from standard noise models. LUR modelling with accurate GIS source data can be a promising tool for noise exposure assessment with applications in epidemiological studies. [ABSTRACT FROM AUTHOR]

The European Union (EU) policy for healthcare requires the establishment of a system of European Reference Networks, union-wide information databases, and registries for rare diseases (RDs) based on shared criteria. In pursuing its goals, the 'Building Consensus and Synergies for the EU Registration of RD Patients in Europe' (EPIRARE) project convened a meeting with experts of the competent health authorities to discuss the role of national institutional RD patient registries in supporting EU patient registration and the room for international cooperation. With this aim, this paper comparatively analyses the current situation of national institutional RD registries in the EU. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article presents information on the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. The project is aimed for the classification of mental disorders. The project was conceived to overcome some of the aforementioned gaps in the knowledge and care of individuals with mental disorders in Europe.

Objective: the study describes the burden of the Italian epidemiological research compared to that of the other 26 countries belonging to the European Union and to that of the United States, in the period 2007-2009. This is accomplished for both scientific published papers and grants obtained., Design and Setting: the searching in Medline database (February 2010) was done through complex search strings based on keywords corresponding to the various epidemiological research fields; grants were identified through 7th Framework Program (FP7), among those funded within February 2010., Main Outcome Measures: proportions of epidemiological papers published by researchers of the different countries and total number and amount of granted research projects for each European country., Results: in the period 2007-2009 epidemiological papers by Italian researchers account for about one-eighth of the total European production. This makes of Italy the second country in production, after the United Kingdom. Moreover, Italy is involved in 51.3%of the 374 studies granted through FP7: at least one Italian research body participates in 154 projects and Italian researches co-ordinate 38 projects., Conclusion: in Italy biomedical and epidemiological research is in a developing phase despite the difficulties due to the decrease in the amount of funds available.Moreover, Italian research is carried out mainly by public bodies and by Universities, even if a deeper involvement of local health authorities and regional agencies is desirable.

This paper reassesses Robert Koch's work on tropical infections of humans and cattle as being inspired by an underlying interest in epidemiology. Such an interest was developed from the early 1890s when it became clear that an exclusive focus on pathogens was insufficient as an approach to explain the genesis and dynamics of epidemics. Koch, who had failed to do so before, now highlighted differences between infection and disease and described the role of various sub-clinical states of disease in the propagation and--consequently--in the control of epidemics. Studying pathologies of men and cattle in tropical countries eventually facilitated the application of such measures in Europe through the screening of healthy carriers of typhoid, which was carried out in 1902. The concept of the carrier state can be understood as a spin-off from tropical medicine into the study and control of infectious disease in Europe. With it travelled assumptions that were typical for colonial and veterinary medicine where the health of indigenous individuals or cattle would be a secondary objective compared to the control of diseases in populations., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

In our global world, the increasing complexity of social relations and transport infrastructures are key factors in the spread of epidemics. In recent years, the increasing availability of computer power has enabled both to obtain reliable data allowing one to quantify the complexity of the networks on which epidemics may propagate and to envision computational tools able to tackle the analysis of such propagation phenomena. These advances have put in evidence the limits of homogeneous assumptions and simple spatial diffusion approaches, and stimulated the inclusion of complex features and heterogeneities relevant in the description of epidemic diffusion. In this paper, we review recent progresses that integrate complex systems and networks analysis with epidemic modelling and focus on the impact of the various complex features of real systems on the dynamics of epidemic spreading.

This paper summarizes Grmek's theoretical contribution to history of disease and explores to what extent the longue durée could still be a useful concept in order to better understand past perceptions of, and reactions to, diseases. The case of the medical responses to epidemic disease in pre-industrial Europe is synthetically expounded in order to illustrate this issue.

Many epidemiological and clinical studies in Europe, especially in Eastern Europe and countries in transition, are of poor methodological quality because of lack of background knowledge in clinical epidemiology methods and study designs. The only way to improve the quality of epidemiological studies is to provide adequate undergraduate and/or postgraduate education for the health professionals and allied health professions. To facilitate this process, the European Federation of Neurological Societies (EFNS) Task Force on teaching of clinical epidemiology in Europe was set up in October 2000. Based on analyses of the current teaching and research activities in neuroepidemiology in Europe, this paper describes the Task Force recommendations aimed to improve these activities.

Objectives: To extend existing research on the US health disadvantage relative to Europe by studying the relationships of disability with age from midlife to old age in the US and four European regions (England/Northern and Western Europe/Southern Europe/Eastern Europe) including their wealth-related differences, using a flexible statistical approach to model the age-functions. Methods: We used data from three studies on aging, with nationally representative samples of adults aged 50 to 85 from 15 countries (N = 48225): the US-American Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE). Outcomes were mobility limitations and limitations in instrumental activities of daily living. We applied fractional polynomials of age to determine best fitting functional forms for age on disability in each region, while controlling for socio-demographic characteristics and important risk factors (hypertension, diabetes, obesity, smoking, physical inactivity). Results: Findings showed high levels of disability in the US with small age-related changes between 50 and 85. Levels of disability were generally lower in Eastern Europe, followed by England and Southern Europe and lowest in Northern and Western Europe. In these latter countries age-related increases of disability, though, were steeper than in the US, especially in Eastern and Southern Europe. For all countries and at all ages, disability levels were higher among adults with low wealth compared to those with high wealth, with largest wealth-related differences among those in early old age in the USA. Conclusions: This paper illustrates considerable variations of disability and its relationship with age. It supports the hypothesis that less developed social policies and more pronounced socioeconomic inequalities are related to higher levels of disability and an earlier onset of disability. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Vega et al. (2012) Influenza surveillance in Europe: establishing epidemic thresholds by the moving epidemic method. Influenza and Other Respiratory Viruses 7(4), 546-558. Background Timely influenza surveillance is important to monitor influenza epidemics. Objectives (i) To calculate the epidemic threshold for influenza-like illness (ILI) and acute respiratory infections (ARI) in 19 countries, as well as the thresholds for different levels of intensity. (ii) To evaluate the performance of these thresholds. Methods The moving epidemic method (MEM) has been developed to determine the baseline influenza activity and an epidemic threshold. False alerts, detection lags and timeliness of the detection of epidemics were calculated. The performance was evaluated using a cross-validation procedure. Results The overall sensitivity of the MEM threshold was 71·8% and the specificity was 95·5%. The median of the timeliness was 1 week (range: 0-4·5). Conclusions The method produced a robust and specific signal to detect influenza epidemics. The good balance between the sensitivity and specificity of the epidemic threshold to detect seasonal epidemics and avoid false alerts has advantages for public health purposes. This method may serve as standard to define the start of the annual influenza epidemic in countries in Europe. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is believed to be frequent among adolescents. While several prospective studies have assessed the use of mental health services among adults who suffer from BPD, few studies have provided adolescent data. This paper presents findings from the first assessment point of the European Research Network on Borderline Personality Disorder (EURNET BPD) study. In this study, we describe lifetime treatment utilization for 85 adolescents with BPD (Mean age: 16.3 years old). In line with adult findings, adolescents with BPD reported greater mental healthcare service use (outpatient: 98%; inpatient: 79%) compared to controls. Phenothiazine, a sedative neuroleptic, was the most frequently prescribed treatment. 47% of patients had received psychotherapy; in one our of three cases this was psychodynamic therapy. Patients who had received psychotherapy did not differ on any psychopathological variables from those who did not receive psychotherapy; however, psychotherapy was more frequent among females. [ABSTRACT FROM AUTHOR]

In this paper, we propose new methods for investigating the extent of heterogeneity in effective contact rates relevant to the transmission of infections. These methods exploit the correlations between ages at infection for different infections within individuals. The methods are developed for serological surveys, which provide accessible individual data on several infections, and are applied to a wide range of infections. We find that childhood infections are often highly correlated within individuals in early childhood, with the correlations persisting into adulthood only for infections sharing a transmission route. We discuss 2 applications of the methods: 1) to making inferences about routes of transmission when these are unknown or uncertain and 2) to estimating epidemiologic parameters such as the basic reproduction number and the critical immunization threshold. Two examples of such applications are presented: elucidating the transmission route of polyomaviruses BK and JC and estimating the basic reproduction number and critical immunization coverage of varicella-zoster infection in Belgium, Italy, Poland, and England and Wales. We speculate that childhood correlations stem from confounding of different transmission routes and represent heterogeneity in childhood circumstances, notably nursery-school attendance. In contrast, it is suggested that correlations in adulthood are route-specific. [ABSTRACT FROM PUBLISHER]

Background: Prolonged sitting is an emerging health risk. However, multi-country comparative sitting data are sparse. This paper reports the prevalence and correlates of sitting time in 32 European countries. Methods: Data from the Eurobarometer 64.3 study were used, which included nationally representative samples (n = 304-1,102) from 32 European countries. Face-to-face interviews were conducted during November and December 2005. Usual weekday sitting time was assessed using the International Physical Activity Questionnaire (short-version). Sitting time was compared by country, age, gender, years of education, general health status, usual activity and physical activity. Multivariable-adjusted analyses assessed the odds of belonging to the highest sitting quartile. Results: Data were available for 27,637 adults aged 15-98 years. Overall, mean reported weekday sitting time was 309 min/day (SD 184 min/day). There was a broad geographical pattern and some of the lowest amounts of daily sitting were reported in southern (Malta and Portugal means 194-236 min/day) and eastern (Romania and Hungary means 191--276 min/day) European countries; and some of the highest amounts of daily sitting were reported in northern European countries (Germany, Benelux and Scandinavian countries; means 407--35 min/day). Multivariable-adjusted analyses showed adults with low physical activity levels (OR = 5.10, CI95 = 4.60-5.66), those with high sitting in their main daily activity (OR = 2.99, CI95 = 2.74-3.25), those with a bad/very bad general health state (OR = 1.87, CI95 = 1.63-2.15) and higher education levels (OR = 1.48, CI95 = 1.38-1.59) were more likely to be in the highest quartile of daily sitting time. Adults within Greece (OR = 2.91, CI95 = 2.51-3.36) and Netherlands (OR = 2.56, CI95 = 2.22-2.94) were most likely to be in the highest quartile. High-sit/low-active participants comprised 10.1% of the sample. Adults self-reporting bad/very bad general health state (OR = 4.74, CI95 = 3.97-5.65), those within high sitting in their main daily activities (OR = 2.87, CI95 = 2.52-3.26) and adults aged ≥65 years (OR = 1.53, CI95 = 1.19-1.96) and were more likely to be in the high-sit/low-active group. Conclusions: Weekday sitting time and its demographic correlates varied considerably across European countries, with adults in north-western European countries sitting the most. Sitting is prevalent across Europe and merits attention by preventive interventions. [ABSTRACT FROM AUTHOR]

This paper presents information on Japan's contribution to reputable epidemiologic journals as compared to other leading countries. Ten journals in the field of epidemiology with high impact factors were selected. Articles published in these journals during the period between 1991 and 2000 were searched for the authors' affiliation using Medline database. We found that Japan contributed only 1.1% of the total number of articles published and ranked 14th among all the countries. The United States of America contributed 56.3% of the total and ranked top followed by the United Kingdom (7.6%), Canada (4.1%), and the Netherlands (3.5%). In a time trend analysis, Japan's share of articles did not increase significantly in the last decade (p = 0.41). Barriers in conducting epidemiologic research in Japan should be identified and appropriate measures should be taken accordingly.

Objective: To provide an overview of incidence and prevalence estimates, admission rates, and related features of psychotic disorders among immigrants from Turkey in Western Europe. Method: Articles published in all languages between 1990 and 2010 were included. In order to detect relevant studies, a string ([schizo*OR psych*] AND [Turk*] AND [migra* OR immigra*]) was used in MEDLINE and PsychINFO. Turkish indexes and abstracts books of national congresses were also screened to locate additional papers. Results: We included 21 studies which yielded 25 rates on psychotic disorders among immigrants from Turkey. Fifteen papers reported rates for the immigrants from Turkey in The Netherlands, four for Germany, one for Denmark and one for Switzerland. The incidence estimates of nonaffective and affective psychosis among immigrants from Turkey were between 38.5 and 44.9 per 100,000 while incidence estimates of schizophrenia were between 12.4 and 63.8 per 100,000. The prevalence estimates of schizophrenia and other psychotic disorders were between 1.1 and 6.2 per 1,000. Rates and relative risks of psychotic disorders in immigrants from Turkey tended to be higher than the natives and lower than other immigrant groups with similar sociocultural background. In addition to other risk factors, social contextual factors including discrimination and neighbourhood characteristics were the key environmental factors that modulate rates of psychotic disorders among immigrants from Turkey. Males were under a higher risk of incidence, prevalence estimates, and admission rates. Conclusion: Variations in rates and relative risks indicate a possible etiological role of social experiences in immigrants. Studies with a focus on comparing the rates and the social factors of psychotic disorders between immigrants from Turkey in Western Europe and their family members residing in Turkey may provide additional insight into the epidemiology of psychotic disorders. [ABSTRACT FROM AUTHOR]