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Background Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries. Methods The Euro-Peristat network implemented this study within the Population Health Information Research Infrastructure (PHIRI) project. A common data model was developed to collect aggregated tables from routine birth data for 2015–2020. SES was based on mother's educational level or area-level deprivation/maternal occupation if education was unavailable and harmonized into low, medium and high SES. Country-specific relative risks (RRs) of PTB and stillbirth for March to December 2020, adjusted for linear trends from 2015 to 2019, by SES group were pooled using random effects meta-analysis. Results Twenty-one countries provided data on perinatal outcomes by SES. PTB declined by an average 4% in 2020 {pooled RR: 0.96 [95% confidence intervals (CIs): 0.94–0.97]} with similar estimates across all SES groups. Stillbirths rose by 5% [RR: 1.05 (95% CI: 0.99–1.10)], with increases of between 3 and 6% across the three SES groups, with overlapping confidence limits. Conclusions PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups. [ABSTRACT FROM AUTHOR]

Porcine Parvovirus (PPV) is one of the most important infectious agents causing severe reproductive failure in pigs. In the last two decades a particular, a novel genotype emerged in Europe and PPV-27a was named as the prototype of this genetic cluster. It was suggested that members of the PPV-27a cluster may adversely influence effective vaccination against PPV. For a reliable updated 27a definition, we aligned 93 databank-deposited partial or full nucleotide and protein sequences of the VP2 of different PPV isolates. We confirmed that the 27a cluster could indeed be distinguished from other members of the species, however, some divergences were identified compared to earlier defined genetic markers. Based on genetic differences, we developed a dual allele-specific polymerase chain reaction for the easy and quick discrimination of members of the 27a cluster from other PPV strains. The detection limit of dual PCR was found <1.66 × 104 copies/reaction. To sensitize and make it more user friendly, the method was further developed for qPCR application with fluorescent probes. Regarding the detection limit of the two PCRs (<1.66 × 104 copies/reaction of the dual PCR versus <2.40 × 102 copy/reaction of the dual qPCR), approximately two log improvement was achieved in the sensitivity of the method. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 pandemic exposed multiple shortcomings in national and international capacity to respond to an outbreak of infectious disease. See Table S1 for data by country. gl Some countries reported disruptions or changes of data procedures related to the pandemic that may impact on quality or completeness, particularly for preliminary data. In these cases, we asked for information about the availability of data to generate stillbirth, preterm birth, low birthweight and caesarean rates, as they are often available earlier than data on neonatal or infant deaths. When several sources were used to generate Euro-Peristat data, we requested information on birth data that could be used to generate stillbirth, preterm and low birthweight rates (as opposed to neonatal or infant deaths, which may become available later). [Extracted from the article]

Litter has been found in all marine environments and is accumulating in seabirds and mammals in the Nordic Seas. These ecosystems are under pressure from climatic change and fisheries while the human population is small. The marine landscapes in the area range from shallow fishing banks to deep-sea canyons. We present density, distribution and composition of litter from the first large-scale mapping of sea bed litter in arctic and subarctic waters. Litter was registered from 1778 video transects, of which 27% contained litter. The background density of litter in the Barents Sea and Norwegian Sea is 202 and 279 items/km 2 respectively, and highest densities were found close to coast and in canyons. Most of the litter originated from the fishing industry and plastic was the second most common litter. Background levels were comparable to European records and areas with most littering had higher densities than in Europe. [ABSTRACT FROM AUTHOR]

Summary: Although substantial efforts have been made to investigate about the composition of the microbiota, fungi that constitute the mycobiota play a pivotal role in maintaining microbial communities and physiological processes in the body. Here, we conducted an international survey focusing on laboratory's current procedures regarding their goals and practices of mycobiota characterisation using NGS. A questionnaire was proposed to laboratories affiliated to working groups from ECMM (NGS study group) and ESCMID (ESGHAMI and EFISG study groups). Twenty‐six questionnaires from 18 countries were received. The use of NGS to characterise the mycobiota was not in routine for most of the laboratories (N = 23, 82%), and the main reason of using NGS was primary to understand the pathophysiology of a dysbiosis (N = 20), to contribute to a diagnosis (N = 16) or to implement a therapeutic strategy (N = 12). Other reported reasons were to evaluate the exposome (environmental studies) (N = 10) or to investigate epidemics (N = 8). Sputum is the main sample studied, and cystic fibrosis represents a major disease studied via the analysis of pulmonary microbiota. No consensus has emerged for the choice of the targets with 18S, ITS1 and ITS2 used alternatively among the laboratories. Other answers are detailed in the manuscript. We report a photography of mycobiota analysis that may become a major tool in the near future. We can draw some conclusions on the diversity of approaches within the answers of the 27 laboratories and underline the need for standardisation. [ABSTRACT FROM AUTHOR]

Earlier studies report inconsistent associations between education and cognitive aging. We assessed the association, accounting for selective dropout due to death or dementia, and, in a subsample, accounting for confounding by early-life intelligence. Data from the Danish component of the Survey of Health, Ageing and Retirement in Europe (n = 3,400) were linked to registry data (education records, dementia diagnoses, and mortality) and the Danish Conscription Database (youth intelligence measurements for 854 men). Word recall and verbal fluency were assessed up to 4 times over 10 years (2004–2013) and combined by averaging the z scores. We fitted a joint model linking a time-to-event model for dementia or death to a linear mixed-effects model for cognitive change. Rate of cognitive decline was slower among people with high education compared with low education (β = 0.112, 95% confidence interval (CI): 0.056, 0.170). Adjusting for youth intelligence did not attenuate the association between education and cognitive decline (crude β = 0.136, 95% CI: 0.028, 0.244 vs. adjusted β = 0.145, 95% CI: 0.022, 0.269). The results suggest that higher education may slow cognitive decline in later life. In this sample, results changed little when accounting for selective attrition and confounding by intelligence. [ABSTRACT FROM AUTHOR]

This study investigates the effects of temperature on the survival, food intake, oxygen consumption and growth during long-term live holding of captive male snow crab (Chionoecetes opilio) (average = 0.7 kg). The crabs were held at three different temperatures, 3, 6 and 9°C. The trials were done using groups of snow crabs held in nine land-based holding tanks (three replicates per temperature treatment). The results showed that temperature had a significant effect on survival. The survival rate at 3°C (61%) was significantly higher than at 6°C (33%) and at 9°C (28%). Specific oxygen consumption rates of unfed crab at 6°C were significantly higher than at 9°C and 3°C. In summary, the current study shows that the Barents Sea snow crab have a narrow temperature range in which they thrive compared with the Barents Sea red king crab (Paralithodes camtschaticus). Barents Sea snow crab has similar metabolic and physiological attributes to other major snow crab populations. In conditions when ambient temperatures are approximately 6°C, it may prove beneficial for animal welfare and also be financially advantageous to reduce ambient water temperatures in live snow crab holding facilities on boat or on land. [ABSTRACT FROM AUTHOR]

Background: The Apgar score has been shown to be predictive of neonatal mortality in clinical and population studies, but has not been used for international comparisons. We examined population-level distributions in Apgar scores and associations with neonatal mortality in Europe.Methods: Aggregate data on the 5 minute Apgar score for live births and neonatal mortality rates from countries participating in the Euro-Peristat project in 2004 and 2010 were analysed. Country level associations between the Apgar score and neonatal mortality were assessed using the Spearman rank correlation coefficient.Results: Twenty-three countries or regions provided data on Apgar at 5 minutes, covering 2 183 472 live births. Scores <7 ranged from 0.3% to 2.4% across countries in 2004 and 2010 and were correlated over time (ρ = 0.88, P < 0.01). There were large differences in healthy baby scores: scores of 10 ranged from 8.8% to 92.7% whereas scores of 9 or 10 ranged from 72.9% to 96.8%. Countries more likely to score 10 s, as opposed to 9 s, for healthy babies had lower proportions of Apgar <7 (ρ = -0.43, P = 0.04). Neonatal mortality rates were weakly correlated with Apgar score <7 (ρ = -0.06, P = 0.61), but differences over time in these two indicators were correlated (ρ =0.56, P = 0.02).Conclusions: Large variations in the distribution of Apgar scores likely due to national scoring practices make the Apgar score an unsuitable indicator for benchmarking newborn health across countries. However, country-level trends over time in the Apgar score may reflect real changes and merit further investigation. [ABSTRACT FROM AUTHOR]

Objective: Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons.Design: Population-based study.Setting: Twenty-seven European countries, the United States, Canada and Japan in 2010.Population: A total of 9 376 252 singleton births.Method: We requested aggregated gestational age data on live births, stillbirths and terminations of pregnancy (TOP) before 32 weeks of gestation, and information on registration practices for these births. We compared VPT rates and assessed the impact of births at 22-23 weeks of gestation, and different criteria for inclusion of stillbirths and TOP on country rates and rankings.Main Outcome Measures: Singleton very preterm birth rate, defined as singleton stillbirths and live births before 32 completed weeks of gestation per 1000 total births, excluding TOP if identifiable in the data source.Results: Rates varied from 5.7 to 15.7 per 1000 total births and 4.0 to 11.9 per 1000 live births. Country registration practices were related to percentage of births at 22-23 weeks of gestation (between 1% and 23% of very preterm births) and stillbirths (between 6% and 40% of very preterm births). After excluding births at 22-23 weeks, rate variations remained high and with a few exceptions, country rankings were unchanged.Conclusions: International comparisons of very preterm birth rates using routine data should exclude births at 22-23 weeks of gestation and terminations of pregnancy. The persistent large rate variations after these exclusions warrant continued surveillance of VPT rates at 24 weeks and over in high-income countries.Tweetable Abstract: International comparisons of VPT rates should exclude births at 22-23 weeks of gestation and terminations of pregnancy. [ABSTRACT FROM AUTHOR]

A generic framework (FW) for the monitoring and evaluation of spatially managed areas (here defined as marine areas subject to a planning and management regime) was developed and tested in nine marine areas of 13 European countries under the EU funded project MESMA (Monitoring and Evaluation of Spatially Managed Areas). This paper describes the lessons learned in the use of the FW and draws conclusions for its future use and development. The selected case studies represented diverse spatial scales, management status and complexity, ranging from sub-national areas to entire national coastlines, and large offshore regions. The application of the FW consisted of seven steps: starting with (i) context setting and (ii) gathering of relevant ecosystem information, human activities and management goals; it continues with (iii) indicator selection and (iv) risk assessment; and the final steps considers the (v) analysis of findings and (vi) the evaluation of management effectiveness, to end up with (vii) the revision and proposal of adaptation to current management. The lessons learnt through the application of the FW in the case studies have proved the value of the FW. However, difficulties rose due to the diversity of the nature and the different stages of development in planning and management in the case study areas; as well as, limited knowledge on ecosystem functioning needed for its implementation. As a conclusion the FW allowed for a flexible and creative application and provided important gap analyses. [ABSTRACT FROM AUTHOR]

Background Stillbirth and neonatal mortality rates declined in Europe between 2004 and 2010. We hypothesised that declines might be greater for countries with higher mortality in 2004 and disproportionally affect very preterm infants at highest risk. Methods Data about live births, stillbirths and neonatal deaths by gestational age (GA) were collected using a common protocol by the Euro-Peristat project in 2004 and 2010. We analysed stillbirths at ≥28 weeks GA in 22 countries and live births ≥24 weeks GA for neonatal mortality in 18 countries. Per cent changes over time were assessed by calculating risk ratios (RR) for stillbirth, neonatal mortality and preterm birth rates in 2010 vs 2004. We used meta-analysis techniques to derive pooled RR using random-effects models overall, by GA subgroups and by mortality level in 2004. Results Between 2004 and 2010, stillbirths declined by 17% (95% CI 10% to 23%), with a range from 1% to 39% by country. Neonatal mortality declined by 29% (95% CI 23% to 35%) with a range from 9% to 67%. Preterm birth rates did not change: 0% (95% CI -3% to 3%). Mortality declines were of a similar magnitude at all GA; mortality levels in 2004 were not associated with RRs. Conclusions Stillbirths and neonatal deaths declined at all gestational ages in countries with both high and low levels of mortality in 2004. These results raise questions about how low-mortality countries achieve continued declines and highlight the importance of improving care across the GA spectrum. [ABSTRACT FROM AUTHOR]

A growing body of work has examined the relationship between media and politics from an agenda-setting perspective: Is attention for issues initiated by political elites with the media following suit, or is the reverse relation stronger? A long series of single-country studies has suggested a number of general agenda-setting patterns but these have never been confirmed in a comparative approach. In a comparative, longitudinal design including comparable media and politics evidence for seven European countries (Belgium, Denmark, France, Netherlands, Spain, Switzerland and the United Kingdom), this study highlights a number of generic patterns. Additionally, it shows how the political system matters. Overall, the media are a stronger inspirer of political action in countries with single-party governments compared to those with multiple-party governments for opposition parties. But, government parties are more reactive to media under multiparty governments. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) is a common sexually transmitted virus that can lead to severe diseases in both women and men. Today, HPV vaccination is offered to females only across Europe. We aimed to examine parental attitudes to HPV vaccination of their sons given brief information about HPV in both genders. Methods: A literature study on acceptability of male HPV vaccination was carried out to inform the construction of a study questionnaire. Following up on a Danish study from 2012, this questionnaire was applied in 1837 computer assisted interviews with parents of sons in the UK, Germany, France and Italy. In each country, the parents were representative in terms of geographical dispersion, city size and age of sons in the household. The applied questionnaires took the varying vaccination policies and delivery systems into account. The data were analysed pooled and for each country using significant statistical tests (chi-2) with a 95 % confidence interval. Results: Approximately 3/4 of parents in the UK, Germany and Italy were in favour of HPV vaccination of their sons. In France, this applied to 49 % of respondents. Favourable parents wanted to protect their sons from disease and found gender equality important. Parents in doubt about male HPV vaccination needed more information about HPV diseases in men and male HPV vaccination; Rejecting parents were generally sceptical of vaccines and feared vaccination side-effects. Parents in countries with active vaccination policies (UK and Italy) tended to trust the importance of national vaccination programmes. Parents in countries with passive vaccination strategies (Germany and France) had greater need for information from health care professionals (HCP) and public health authorities. Conclusion: Given brief information about HPV in both genders, parental acceptance of HPV vaccination of sons is as high as acceptance levels for girls. All parents should be informed about HPV to make informed decisions about HPV vaccination for their children. There is a need for joint efforts from public health authorities and HCPs to provide parents with such information. [ABSTRACT FROM AUTHOR]

To examine whether an excess risk of maternal mortality exists among migrant women in Western Europe. We searched electronic databases for studies published 1970 through 2013 for all observational studies comparing maternal mortality between the host country and a defined migrant population. Results were derived from a random-effects meta-analysis, and statistical heterogeneity assessed by the I statistic. In sub-analyses we also calculated summary estimates stratified by direct and indirect death causes. We included 13 studies with more than 42 million women and 4,995 maternal deaths. Compared with indigenous born women, the pooled risk estimate (RR) was 2.00 with 95 % confidence interval (CI) of 1.72, 2.33. Migrant women had a non-significantly higher risk of dying from direct than indirect death causes; pooled RRs of 2.65 CI 1.88, 3.74 and 1.83 CI 1.37, 2.45. This meta-analysis provides evidence that migrant women in Western European countries have an excess risk of maternal mortality. [ABSTRACT FROM AUTHOR]

Internationalisation is a buzzword in European higher education, and many universities work hard to devise and implement strategies that will help facilitate increased transnational student mobility. In this context, English is commonly seen as the ‘natural’ choice for university internationalisation, and English is accordingly promoted as the ‘obvious’ language of instruction for international education in many university policies. This article argues that the idea that university internationalisation should equal the exclusive use of English as a lingua franca is essentially misguided. Not only is it at odds with the available empirical evidence, it also puts unnecessary constraints on the potential that transnational education holds for cultural and linguistic exchange and development. The article is based on a case study where the patterns of language choice of three student project groups at an international study programme in Denmark were analysed quantitatively and qualitatively. The analysis shows that although there is a quantitative preference for English in the three groups which matches the general pro-English language ideology at the programme, the groups have nevertheless, to varying degrees, developed practice-based language policies ‘from below’ that allow for alternating and sometimes syncretic use of English and Danish. [ABSTRACT FROM PUBLISHER]

Abstract: The EUNIS (European Union Nature Information System) habitat classification system aims to provide a common European reference set of habitat types within a hierarchical classification, and to cover all terrestrial, freshwater and marine habitats of Europe. The classification facilitates reporting of habitat data in a comparable manner, for use in nature conservation (e.g. inventories, monitoring and assessments), habitat mapping and environmental management. For the marine environment the importance of a univocal habitat classification system is confirmed by the fact that many European initiatives, aimed at marine mapping, assessment and reporting, are increasingly using EUNIS habitat categories and respective codes. For this reason substantial efforts have been made to include information on marine benthic habitats from different regions, aiming to provide a comprehensive geographical coverage of European seas. However, there still remain many concerns on its applicability as only a small fraction of Europe’s seas are fully mapped and increasing knowledge and application raise further issues to be resolved. This paper presents an overview of the main discussion and conclusions of a workshop, organised by the MeshAtlantic project, focusing upon the experience in using the EUNIS habitats classification across different countries and seas, together with case studies. The aims of the meeting were to: (i) bring together scientists with experience in the use of the EUNIS marine classification and representatives from the European Environment Agency (EEA); (ii) agree on enhancements to EUNIS that ensure an improved representation of the European marine habitats; and (iii) establish practices that make marine habitat maps produced by scientists more consistent with the needs of managers and decision-makers. During the workshop challenges for the future development of EUNIS were identified, which have been classified into five categories: (1) structure and hierarchy; (2) biology; (3) terminology; (4) mapping; and (5) future development. The workshop ended with a declaration from the attendees, with recommendations to the EEA and European Topic Centre on Biological Diversity, to take into account the outputs of the workshop, which identify weaknesses in the current classification and include proposals for its modification, and to devise a process to further develop the marine component of the EUNIS habitat classification. [Copyright &y& Elsevier]

Abstract: The assessment of employment prospects during the period up to 2020 needs to take into account the effects of the 2008/2009 downturn. We propose two scenarios that capture distinctive trajectories in order to elucidate some of the potential strategic demands for future employment policy. We forecast the average level of education of the working-age population will increase significantly during this decade and therefore the mismatch between the needs and supply of skills is likely to be significantly reduced. Furthermore, the inherent mobility of the working population will increase together with higher levels of education. [Copyright &y& Elsevier]

The distribution of attention across issues is of fundamental importance to the political agenda and outputs of government. This article presents an issue-based theory of the diversity of governing agendas where the core functions of government—defense, international affairs, the economy, government operations, and the rule of law—are prioritized ahead of all other issues. It undertakes comparative analysis of issue diversity of the executive agenda of several European countries and the United States over the postwar period. The results offer strong evidence of the limiting effect of core issues—the economy, government operations, defense, and international affairs—on agenda diversity. This suggests not only that some issues receive more attention than others but also that some issues are attended to only at times when the agenda is more diverse. When core functions of government are high on the agenda, executives pursue a less diverse agenda—focusing the majority of their attention on fewer issues. Some issues are more equal than others in executive agenda setting. [ABSTRACT FROM PUBLISHER]

Abstract: The Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD) are the European umbrella regulations for water systems. It is a challenge for the scientific community to translate the principles of these directives into realistic and accurate approaches. The aim of this paper, conducted by the Benthos Ecology Working Group of ICES, is to describe how the principles have been translated, which were the challenges and best way forward. We have tackled the following principles: the ecosystem-based approach, the development of benthic indicators, the definition of ‘pristine’ or sustainable conditions, the detection of pressures and the development of monitoring programs. We concluded that testing and integrating the different approaches was facilitated during the WFD process, which led to further insights and improvements, which the MSFD can rely upon. Expert involvement in the entire implementation process proved to be of vital importance. [ABSTRACT FROM AUTHOR]

Background: To study the trend of diagnosing dementia in the secondary health care sector over time, we conducted a nationwide longitudinal study of the incidence and prevalence of registered dementia diagnoses in the Danish national hospital registers. Methods: All Danish residents born before 1964 and alive at their 40th birthday were followed from their 40th birthday or January 1, 1970, whichever came later, to the date of the first dementia diagnosis recorded in the hospital registers, the date of emigration, date of death, or December 31, 2004, whichever came first. The age- and period-specific incidence and prevalence of dementia were calculated and compared to estimates from large community-based cohort studies in Europe. Results: The study population consisted of 4,723,838 persons with 81,090,583 person-years of follow-up. 154,152 dementia cases were registered from 1970 to 2004. The incidence and prevalence of registered dementia diagnoses showed an increasing trend over time. In 2003, the age-standardized incidence rate ratio was 0.66 when compared to estimates from large European community-based cohort studies. Conclusions: The study shows a marked improvement in the diagnostic rate of dementia in secondary care over time and indicates that this sector can be an important point of entry for patients with dementia. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: The National UK IBD audit tool is an electronic database created to improve the quality and safety of care for IBD patients by auditing individual patient care, service resources and organisation against national standards. We used the National UK IBD audit tool to compare the organisation and process of IBD care between services in Oxford (UK) and Milan (Italy), as a pilot study to evaluate its application outside national boundaries. Methods: Clinical and demographic data of patients with CD and UC, consecutively admitted during a 2month period, were collected and compared between the centres, to each other and to the UK IBD standards obtained by previous audit analyses performed in Oxford in 2006. Results: 20 and 26 patients with UC were admitted in Oxford and Milan, as well as 21 and 20 patients with CD, respectively. Most admissions in Milan were planned admissions for moderately active treatment-refractory disease. No patient died. Oxford had a higher surgery rate. Endoscopy for UC consisted mainly of colonoscopy in Milan (92%) and flexible sigmoidoscopy in Oxford (64%). In CD, Oxford data revealed a higher use of immununomodulators and CT scan, compared with higher use of bowel ultrasound in Milan. CRP was the preferred biomarker of disease activity. The following areas did not reach the standards set for the 2006 UK IBD Audit: the lack in Milan of IBD specialist nurses and few dietitian visits, as well as little attention to heparin prophylaxis and abdominal radiography in UC. Both sites paid little attention to stool cultures and revealed a high rate of active smokers in CD and little attention to bone protection in steroids users. Since the 2006 audit in Oxford, improvements include IBD specialist nurse visits, dietitian visits, number of active smokers, stool samples, prophylactic heparin, bone protection and nutritional assessment. Conclusions: Consistent procedural differences between Oxford and Milan identified by audits of both UC and CD could be resolved by organisational change, with an improvement in the service. The UK IBD audit tool is an easy instrument to assess the processes and outcomes of care delivery in IBD and can be applied also outside UK. [Copyright &y& Elsevier]

Reports on the demonstration of a 36-kilovolt two-kiloampere[sub rms] alternating current high temperature superconducting (HTS) cable system in Europe. Installation of a 30-meter long full-scale functional model in a power utility substation; Aim of linking two medium-voltage transformer stations; Utility studies; Cable system description.

This article explores the proposed European Co. as a means to cross-border mergers within the European Community. The European Community's new merger regulation has generated considerable discussion. The regulation, though riddled with exceptions, is intended to provide one-stop approval for mergers and acquisitions having a community dimension. The present proposal for a European Co. differs from its predecessors in that it has been divided into a regulation that would as a mailer of EC law uniformly govern the founding, activity, and dissolution of the company, and a directive that would, with some deference to the different employment laws of the Member States, govern the participation rights of workers. The regulation would open the door to cross-border asset mergers by authorizing the formation of an SE by two or more public limited companies (PLCs), provided each PLC has previously been formed under the law of a Member State, and provided at least two of the companies merging had their central administration in different Member States. INSET: Balancing Corporate and Local Information Management Needs..

The article presents opinion from several European doctors concerning the ways investment in health care could be good for Europe's economies. The results of a European report which shows that the benefits of improved public health care are likely to extend beyond reduced healthcare costs, are discussed.

Introduction and description of care: The management of non-healing wounds in Europe has gone through a dramatic shift in the location of service delivery from hospital towards home care settings. As a consequence more wounds with complex pathological pictures due to untreated patient co-morbidities are treated at home. There are no guidelines available covering the subject of home-care wound-management from a clinical perspective as well as no recommendations of minimal requirement of providing best care and supporting the empowerment of informal carers and patients with non-healing wounds in the home-care setting. Methods and aim: Based on literature reviews in combination with expert opinions from across sectors and areas of expertise a document was elaborated to give an overview of the main current approaches to the organisation of wound care within home-care settings, to identify possible barriers, challenges and opportunities for providing modern, cost-efficient, interdisciplinary wound care. The document has been developed in an intersectoral collaboration across European countries and organisations between the Tissue Viability Society (UK), Initiative Chronische Wunden (Germany), HomeCare Europe and EWMA. Thus, the focus is interdisciplinary and not tied to a specific health care system. Conclusion and discussion: Describing recommendations and raising a debate of how to manage non-healing wounds at home is of crucial importance for healthcare professionals, - providers, companies and policy makers as there is a tendency in home care of going towards employment of non-registered nurses. The document underlines the importance, scope, and level of the appropriate skills and gives recommendations for the interdisciplinary set-up required for wound care in the home-care setting. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that socioeconomic position is inversely associated with stillbirth risk, but the impact on national rates in Europe is not known. We aimed to assess the magnitude of social inequalities in stillbirth rates in European countries using indicators generated from routine monitoring systems.Methods: Aggregated data on the number of stillbirths and live births for the year 2010 were collected for three socioeconomic indicators (mothers' educational level, mothers' and fathers' occupational group) from 29 European countries participating in the Euro-Peristat project. Educational categories were coded using the International Standard Classification of Education (ISCED) and analysed as: primary/lower secondary, upper secondary and postsecondary. Parents' occupations were grouped using International Standard Classification of Occupations (ISCO-08) major groups and then coded into 4 categories: No occupation or student, Skilled/ unskilled workers, Technicians/clerical/service occupations and Managers/professionals. We calculated risk ratios (RR) for stillbirth by each occupational group as well as the percentage population attributable risks using the most advantaged category as the reference (post-secondary education and professional/managerial occupations).Results: Data on stillbirth rates by mothers' education were available in 19 countries and by mothers' and fathers' occupations in 13 countries. In countries with these data, the median RR of stillbirth for women with primary and lower secondary education compared to women with postsecondary education was 1.9 (interquartile range (IQR): 1.5 to 2.4) and 1.4 (IQR: 1.2 to 1.6), respectively. For mothers' occupations, the median RR comparing outcomes among manual workers with managers and professionals was 1.6 (IQR: 1.0-2.1) whereas for fathers' occupations, the median RR was 1.4 (IQR: 1.2-1.8). When applied to the entire set of countries with data about mothers' education, 1606 out of 6337 stillbirths (25 %) would not have occurred if stillbirth rates for all women were the same as for women with post-secondary education in their country.Conclusions: Data on stillbirths and socioeconomic status from routine systems showed widespread and consistent socioeconomic inequalities in stillbirth rates in Europe. Further research is needed to better understand differences between countries in the magnitude of the socioeconomic gradient. [ABSTRACT FROM AUTHOR]

Local treatment improves the outcomes for oligometastatic disease (OMD, i.e. an intermediate state between locoregional and widespread disseminated disease). However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The aim of this study was to develop a multidisciplinary European consensus statement on the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer. In total, 65 specialists in the multidisciplinary treatment for oesophagogastric cancer from 49 expert centres across 16 European countries were requested to participate in this Delphi study. The consensus finding process consisted of a starting meeting, 2 online Delphi questionnaire rounds and an online consensus meeting. Input for Delphi questionnaires consisted of (1) a systematic review on definitions of oligometastatic oesophagogastric cancer and (2) a discussion of real-life clinical cases by multidisciplinary teams. Experts were asked to score each statement on a 5-point Likert scale. The agreement was scored to be either absent/poor (<50%), fair (50%–75%) or consensus (≥75%). A total of 48 experts participated in the starting meeting, both Delphi rounds, and the consensus meeting (overall response rate: 71%). OMD was considered in patients with metastatic oesophagogastric cancer limited to 1 organ with ≤3 metastases or 1 extra-regional lymph node station (consensus). In addition, OMD was considered in patients without progression at restaging after systemic therapy (consensus). For patients with synchronous or metachronous OMD with a disease-free interval ≤2 years, systemic therapy followed by restaging to consider local treatment was considered as treatment (consensus). For metachronous OMD with a disease-free interval >2 years, either upfront local treatment or systemic treatment followed by restaging was considered as treatment (fair agreement). The OMEC project has resulted in a multidisciplinary European consensus statement for the definition, diagnosis and treatment of oligometastatic oesophagogastric adenocarcinoma and squamous cell cancer. This can be used to standardise inclusion criteria for future clinical trials. [Display omitted] • A European consensus statement for oesophagogastric oligometastatic disease (OMD) was developed. • 1 organ with ≤3 metastases or 1 involved extra-regional lymph node station is OMD. • No progression at restaging after systemic therapy remains OMD. • This consensus statement requires prospective validation in a clinical study. [ABSTRACT FROM AUTHOR]

African swine fever (ASF) is a notifiable infectious disease with a considerable impact on animal health and is currently one of the most important emerging diseases of domestic pigs. ASF was introduced into Georgia in 2007 and subsequently spread to the Russian Federation and several Eastern European countries. Consequently, there is a non-negligible risk of ASF spread towards Western Europe. Therefore it is important to develop tools to improve our understanding of the spread and control of ASF for contingency planning. A stochastic and dynamic spatial spread model (DTU-DADS) was adjusted to simulate the spread of ASF virus between domestic swine herds exemplified by the Danish swine population. ASF was simulated to spread via animal movement, low- or medium-risk contacts and local spread. Each epidemic was initiated in a randomly selected herd – either in a nucleus herd, a sow herd, a randomly selected herd or in multiple herds simultaneously. A sensitivity analysis was conducted on input parameters. Given the inputs and assumptions of the model, epidemics of ASF in Denmark are predicted to be small, affecting about 14 herds in the worst-case scenario. The duration of an epidemic is predicted to vary from 1 to 76 days. Substantial economic damages are predicted, with median direct costs and export losses of €12 and €349 million, respectively, when epidemics were initiated in multiple herds. Each infectious herd resulted in 0 to 2 new infected herds varying from 0 to 5 new infected herds, depending on the index herd type. [ABSTRACT FROM AUTHOR]

The OligoMetastatic Esophagogastric Cancer (OMEC) project aims to provide clinical practice guidelines for the definition, diagnosis, and treatment of esophagogastric oligometastatic disease (OMD). Guidelines were developed according to AGREE II and GRADE principles. Guidelines were based on a systematic review (OMEC-1), clinical case discussions (OMEC-2), and a Delphi consensus study (OMEC-3) by 49 European expert centers for esophagogastric cancer. OMEC identified patients for whom the term OMD is considered or could be considered. Disease-free interval (DFI) was defined as the time between primary tumor treatment and detection of OMD. Moderate to high quality of evidence was found (i.e. 1 randomized and 4 non-randomized phase II trials) resulting in moderate recommendations. OMD is considered in esophagogastric cancer patients with 1 organ with ≤ 3 metastases or 1 involved extra-regional lymph node station. In addition, OMD continues to be considered in patients with OMD without progression in number of metastases after systemic therapy. 18F-FDG PET/CT imaging is recommended for baseline staging and for restaging after systemic therapy when local treatment is considered. For patients with synchronous OMD or metachronous OMD and a DFI ≤ 2 years, recommended treatment consists of systemic therapy followed by restaging to assess suitability for local treatment. For patients with metachronous OMD and DFI > 2 years, upfront local treatment is additionally recommended. These multidisciplinary European clinical practice guidelines for the uniform definition, diagnosis and treatment of esophagogastric OMD can be used to standardize inclusion criteria in future clinical trials and to reduce variation in treatment. [Display omitted] • Multidisciplinary European clinical practice guidelines were developed. • One organ with ≤ 3 metastases is considered OMD. • One extra-regional lymph node station is considered OMD. • Patients with OMD undergo systemic therapy followed by restaging. • Patients without progression at 18F-FDG PET/CT restaging undergo local treatment. [ABSTRACT FROM AUTHOR]

African swine fever (ASF) is caused by ASF virus (ASFV) and is currently circulating in the eastern part of Europe posing a serious risk regarding transmission to western European countries. Wild boar is a main driver of the transmission and persistence of ASFV in the endemic infected countries in Europe. Some European countries free from ASF, such as Denmark and the Netherlands, have limited population sizes of wild boar, but have large swine productions. In these countries, the patterns of transmission and persistence of ASFV in the existing wild boar population, in case of introduction of ASFV, are unknown. It is important to get a better understanding of ASFV in these wild boar populations, in order to better manage the existing wild boar population and thereby minimize the risk of virus introduction and transmission to domestic pigs, in case of an ASFV incursion. We created an agent-based spatio-temporal model and simulated the transmission of ASFV within Danish wild boar populations, using actual landscape data. The model was run with 50 and 100 wild boar groups used as initial population sizes, respectively, either distributed across the southern part of the mainland (Jutland) or across both the southern and middle parts of Jutland, where wild boar groups are believed to exist. At first, the model was run without ASFV for 25 years to assess wild boar population dynamics in both regions. Thereafter, ASFV was added to the model 1 year after initiation and run for up to another 4 years. The model predicted that wild boar populations may increase drastically over the next 25 years, if wild boar groups were distributed across both southern and middle Jutland and no mitigation actions were taken, while the population sizes will be restricted, if groups were distributed only across the southern part of Jutland. The density of the population is an important factor affecting the transmission and persistency of the disease. Model results indicated that ASF epidemics in the simulated populations would generally persist for few months. However, due to the high stochasticity of the process, in certain situations the epidemics may last for more than one year, posing a serious risk of ASFV introduction to domestic pigs. [ABSTRACT FROM AUTHOR]

In Europe, over 70 million people are annually suffering from anxiety and stress-related disorders and over 90% of patients with these disorders have another comorbid mental or somatic disorder. Therefore, it is of strong interest to identify the risk factors of these disorders. Heritability estimates vary between 30% and 50%, however first Genome-Wide Association Studies (GWAS) have been limited by their small sample sizes. As anxiety and stress-related disorders are likely to configure various expressions of abnormalities in the basic stress-response system, we aimed to conduct a GWAS aggregating a large number of cases with varying diagnoses of anxiety and stress-related disorders. The study is making use of a Danish nation-wide population-based sample collected by the Lundbeck Foundation Initiative for Integrative Psychiatric Research including 14,711 cases with anxiety and stress-related diagnoses and 17,857 controls. Data were processed using the Ricopili pipeline; imputation is based on the 1000 genomes phase 3 as reference panel. GWAS was conducted using the imputed marker dosages and an additive logistic regression model. Analyses were supplemented by comparing severe mental disorder with comorbid anxiety and stress-related disorder to those without, using a propensity-score-matched design. SNP heritability and genetic correlation with other traits were computed using LD-score regression. In case-control design several SNPs located in the PDE4B gene achieved genome-wide significance. The analyses comparing mental disorders with and without comorbid anxiety and stress-related disorders reveled no significant signal. The SNP heritability estimate for anxiety was 14%, 33% for stress-related disorders and 26% for the combined phenotype. We found a positive significant genetic correlation of anxiety and stress-related disorders with neuroticism, depression, bipolar disorder, schizophrenia and smoking; and a negative genetic correlation with college completion, years of schooling, age at menarche and age of first birth. This is the first GWAS meta-analysis on anxiety and stress-related disorders demonstrating influences of common genetic variation in the etiology of these disorders and indicating PDE4B as a susceptibility locus. Consistent with phenotypic observations, anxiety and stress-related disorders share genetic variants with psychiatric traits in the expected direction. [ABSTRACT FROM AUTHOR]