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Satisfaction with the detection process of autism and its determinants was investigated using data from the Autism Spectrum Disorder in the European Union (2015-2018) network. A total of 1342 family members, including 1278 parents, completed an online survey collecting information about their experience and satisfaction with the early detection of autism in their child. Overall, the level of satisfaction varied considerably from one respondent to another. Difficulty in finding information about detection services, lack of professional guidance and support in response to first concerns, finding a diagnostic service on one's own, and a delay of more than 4 months between the confirmation of concerns and the first appointment with a specialist were all experiences individually associated with greater odds of being less satisfied. Using a dominance analysis approach, we further identified professional guidance and support in response to first concerns as the most important predictor of the level of satisfaction. These findings highlight the aspects of the process that need to be improved to enhance the experience of the detection process and are therefore relevant to guide health administrations toward actions to be implemented to this effect.

Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data from 2032 respondents across 14 European countries (60.9% were parents; 39.1% professionals). Using an ordinal scale from 1 to 7, parents' opinions were more negative (mean = 4.6; SD 2.2) compared to those of professionals (mean = 4.9; SD 1.5) when reporting satisfaction with services. The results suggest services should take into account child's age, delays in accessing services, and active stakeholders' participation when looking to improve services.

The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated local services' use experiences of autistic adults, carers and professionals with interventions for autistic adults. The majority of the 697 participants experienced recommended considerations prior to deciding on intervention and during the intervention plan and implementation. Psychosocial interventions were the most commonly experienced interventions, while pharmacological interventions NOT recommended for core autistic symptoms were reported by fairly large proportions of participants. Family interventions were experienced slightly more commonly by carers than adults or professionals. Less than the 26% of autistic adult responders who had experienced challenging behaviors reported receiving an intervention to change them. These results provide insights for improving gaps in service provision of interventions among autistic adults. [ABSTRACT FROM AUTHOR]

Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and post-diagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, < 2% of adults or carers, and < 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals. [ABSTRACT FROM AUTHOR]

Background: This study addresses the need for a theoretical base to develop more effective early autism spectrum disorders (ASD) detection tools. The structure that underlies early ASD detection is explored by evaluating the opinions of experts on ASD screening tools currently used in Europe. Method: A process of face and content validity was performed. First, the best constructs were selected from the relevant tests: Checklist for Early Signs of Developmental Disorders (CESDD), Checklist for Autism in Toddlers (CHAT), Early Screening of Autistic Traits Questionnaire (ESAT), Modified Checklist for Autism in Toddlers (M‐CHAT), Social Communication Questionnaire (SCQ) and Communication and Symbolic Behaviour Scales Developmental Profile (CSBS‐DP). The diagnostic content validity model by Fehring (1986, 1994) was adapted to make the selection. Afterwards, the items, taken from these tests, were selected to fit into each construct, using the same methodology. Results: Twelve of the 18 constructs were selected by the experts and 11 items were chosen from a total of 130, reduced to eight after eliminating tautologies. Conclusions: Mapping these constructs and items on to the DSM‐5 diagnostic criteria for ASD indicated good face and content validity. Results of this research will contribute to efforts to improve early ASD screening instruments and identify the key behaviours that experts in ASD see as the most relevant for early detection. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorders (ASDs), once considered to be rare, are now reaching prevalence estimates of 1% and higher. Studies conducted in North America indicate large racial/ethnic disparities in the diagnosis of ASDs. Others show, that immigrant children have similar prevalence rates of ASDs as native children, although they are diagnosed later compared with native children. In relation to a EU funded network action, Enhancing the Scientific Study of Early Autism, it was considered important to review the literature on this subject. Method: A comprehensive literature search was undertaken for original articles reporting on prevalence and risk for ASD in Europe among immigrants and ethnic minorities and data across studies were compared. Results: Seventeen studies conducted in Europe concerning immigrants and ethnic minorities were found. Fifteen studies suggest a higher prevalence rate of ASDs among children of immigrants in comparison to native children (RR = 1.02-1.74; OR =0.6-10.5). One study revealed higher prevalence of autism (OR = 2.2; 95% CI 1.6-3.1) and lower prevalence of Asperger syndrome in immigrants (OR = 0.6; 95% CI 0.3-0.97). One study showed a lower prevalence of Asperger syndrome in immigrants (aOR = 0.1, 95% CI 0.01-0.5). The majority of those analyses involved immigrants from outside Europe, e.g. from Africa and South America. Conclusion: After analysing the results of studies conducted in Europe, it is unclear if higher prevalence estimates of ASDs among immigrants in this region reflect true differences, especially considering many potential confounding factors, e.g. genetic, biological, environmental and cultural. Considering the number of people migrating within Europe there is a substantial need to study further the prevalence of ASDs in immigrant groups. [ABSTRACT FROM AUTHOR]

A large number of studies have reported on the validity of autism spectrum disorder (ASD) screening procedures. An overall understanding of these studies' findings cannot be based solely on the level of internal validity of each, since screening instruments might perform differently according to certain factors in different settings. Europe has led the field with the development of the first screening tool and first prospective screening study of autism. This paper seeks to provide an overview of ASD screening studies and ongoing programmes across Europe, and identify variables that have influenced the outcomes of such studies. Results show that, to date, over 70,000 children have been screened in Europe using 18 different screening procedures. Differences among findings across studies have enabled us to identify ten factors that may influence screening results. Although it is impossible to draw firm conclusions as to which screening procedure is most effective, this analysis might facilitate the choice of a screening method that best fits a specific scenario, and this, in turn, may eventually improve early ASD detection procedures. [ABSTRACT FROM AUTHOR]

Abstract: The Natura 2000 (N2k) network of protected areas is a backbone of biodiversity conservation in Europe, with likely further relevance for the development of green infrastructure. EU member states have legal responsibilities for evaluating the condition of and maintaining their national networks. While it is desirable to maintain the condition of the N2k network or even improve it by habitat restoration, it is a fact that national environmental bodies operate under budgetary constraints – money available for conservation is limited. Consequently, there may be a need to prioritize targeting of conservation effort in and around the N2k network. In this study we develop a high-resolution spatial conservation prioritization for the Finnish national N2k network, using data about the distribution and quality of 68 N2k habitats occurring in Finland. The aim of the work is to identify management landscapes, landscapes that have exceptionally high conservation value and which could be managed as one management unit. We identify top-priority areas of the N2k network. We also identify highest-priority N2k areas that do not have the status of a protected area in the Finnish legislation. The present work was commissioned by the Natural Heritage Services of Metsähallitus, a national administrator that is responsible for the maintenance of the Finnish protected area network. The primary purpose of this work is to assist targeting of habitat maintenance, management and restoration in and around the Finnish N2k network. The analysis done here could be replicated elsewhere using publicly available spatial prioritization software. [Copyright &y& Elsevier]

This article contributes to the discussion about spatial planning in and for Europe by discussing territoriality in the strategies and practices of the territorial cohesion policy of the European Union (EU). The need for new ways of thinking and acting spatially are strongly promoted within the EU's spatial development policies, and the addition of territorial cohesion as one of the main objectives of the EU alongside the economic and social cohesion has brought the debate on European spatial planning back onto the political agenda. Territorial cohesion policy advocates the idea of soft planning, where new soft planning spaces cross the administrative borders within the EU territory. Accordingly, strategic planning and development policies at national and regional levels are engaged with the policy by promoting soft spatial imaginaries characterized by relational understandings of space. The article explores through two empirical materials related to the Member States’ definitions about territorial cohesion and the case of the Bothnian Arc, whether, and if so, how, the new soft planning spaces are visible in the conceptualizations and regional-level practices of territorial cohesion policy. The study illustrates that the conceptualizations of territorial cohesion and regional practices still lean on traditional understandings of territoriality. Clearly, there are mismatches between the soft planning visions for single European space and the practical development governed through traditional administrative territories. [ABSTRACT FROM PUBLISHER]

Most cases of hemorrhagic fever with renal syndrome (HFRS) in Europe are caused by the Puumala hantavirus (PUUV). Typical features of the disease are increased vascular permeability, acute kidney injury (AKI), and thrombocytopenia. YKL-40 is an inflammatory glycoprotein involved in various forms of acute and chronic inflammation. In the present study, we examined plasma YKL-40 levels and the associations of YKL-40 with disease severity in acute PUUV infection. A total of 79 patients treated in Tampere University Hospital during 2005–2014 were studied. Plasma YKL-40 was measured in the acute phase, the recovery phase, and one year after hospitalization. Plasma YKL-40 levels were higher during the acute phase compared to the recovery phase and one year after hospitalization (median YKL-40 142 ng/mL, range 11–3320, vs. 45 ng/mL, range 15–529, vs. 32 ng/mL, range 3–213, p < 0.001). YKL-40 level was correlated with the length of hospital stay (r = 0.229, p = 0.042), the levels of inflammatory markers—that is, blood leukocytes (r = 0.234, p = 0.040), plasma C-reactive protein (r = 0.332, p = 0.003), and interleukin-6 (r = 0.544, p < 0.001), and maximum plasma creatinine level (r = 0.370, p = 0.001). In conclusion, plasma YKL-40 levels were found to be elevated during acute PUUV infection and correlated with the overall severity of the disease, as well as with the degree of inflammation and the severity of AKI. [ABSTRACT FROM AUTHOR]

The prosperity and well-being of human societies relies on healthy ecosystems and the services they provide. However, the biodiversity crisis is undermining ecosystems services and functions. Vultures are among the most imperiled taxonomic groups on Earth, yet they have a fundamental ecosystem function. These obligate scavengers rapidly consume large amounts of carrion and human waste, a service that may aid in both disease prevention and control of mammalian scavengers, including feral dogs, which in turn threaten humans. We combined information about the distribution of all 15 vulture species found in Europe, Asia, and Africa with their threats and used detailed expert knowledge on threat intensity to prioritize critical areas for conserving vultures in Africa and Eurasia. Threats we identified included poisoning, mortality due to collision with wind energy infrastructures, and other anthropogenic activities related to human land use and influence. Areas important for vulture conservation were concentrated in southern and eastern Africa, South Asia, and the Iberian Peninsula, and over 80% of these areas were unprotected. Some vulture species required larger areas for protection than others. Finally, countries that had the largest share of all identified important priority areas for vulture conservation were those with the largest expenditures related to rabies burden (e.g., India, China, and Myanmar). Vulture populations have declined markedly in most of these countries. Restoring healthy vulture populations through targeted actions in the priority areas we identified may help restore the ecosystem services vultures provide, including sanitation and potentially prevention of diseases, such as rabies, a heavy burden afflicting fragile societies. Our findings may guide stakeholders to prioritize actions where they are needed most in order to achieve international goals for biodiversity conservation and sustainable development., (© 2019 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.)

Climate change is affecting biodiversity worldwide, but conservation responses are constrained by considerable uncertainty regarding the magnitude, rate and ecological consequences of expected climate change. Here we propose a framework to account for several sources of uncertainty in conservation prioritization. Within this framework we account for uncertainties arising from (i) species distributions that shift following climate change, (ii) basic connectivity requirements of species, (iii) alternative climate change scenarios and their impacts, (iv) in the modelling of species distributions, and (v) different levels of confidence about present and future. When future impacts of climate change are uncertain, robustness of decision-making can be improved by quantifying the risks and trade-offs associated with climate scenarios. Sensible prioritization that accounts simultaneously for the present and potential future distributions of species is achievable without overly jeopardising present-day conservation values. Doing so requires systematic treatment of uncertainties and testing of the sensitivity of results to assumptions about climate. We illustrate the proposed framework by identifying priority areas for amphibians and reptiles in Europe.