Hasil untuk "Europe (General)"

R. De Angelis, M. Sant, M. Coleman et al.

Ferrari Anusca

L. Aiken, W. Sermeus, Koen Van den Heede et al.

Objective To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. Design Cross sectional surveys of patients and nurses. Setting Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. Participants 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. Main outcome measures Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). Results The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients’ high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care (1.11, 1.07 to 1.15) and poor or failing safety grades (1.10, 1.05 to 1.16). Patients in hospitals with better work environments were more likely to rate their hospital highly (1.16, 1.03 to 1.32) and recommend their hospitals (1.20, 1.05 to 1.37), whereas those with higher ratios of patients to nurses were less likely to rate them highly (0.94, 0.91 to 0.97) or recommend them (0.95, 0.91 to 0.98). Results were similar in the US. Nurses and patients agreed on which hospitals provided good care and could be recommended. Conclusions Deficits in hospital care quality were common in all countries. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.

J. Damen, L. Hooft, E. Schuit et al.

Objective To provide an overview of prediction models for risk of cardiovascular disease (CVD) in the general population. Design Systematic review. Data sources Medline and Embase until June 2013. Eligibility criteria for study selection Studies describing the development or external validation of a multivariable model for predicting CVD risk in the general population. Results 9965 references were screened, of which 212 articles were included in the review, describing the development of 363 prediction models and 473 external validations. Most models were developed in Europe (n=167, 46%), predicted risk of fatal or non-fatal coronary heart disease (n=118, 33%) over a 10 year period (n=209, 58%). The most common predictors were smoking (n=325, 90%) and age (n=321, 88%), and most models were sex specific (n=250, 69%). Substantial heterogeneity in predictor and outcome definitions was observed between models, and important clinical and methodological information were often missing. The prediction horizon was not specified for 49 models (13%), and for 92 (25%) crucial information was missing to enable the model to be used for individual risk prediction. Only 132 developed models (36%) were externally validated and only 70 (19%) by independent investigators. Model performance was heterogeneous and measures such as discrimination and calibration were reported for only 65% and 58% of the external validations, respectively. Conclusions There is an excess of models predicting incident CVD in the general population. The usefulness of most of the models remains unclear owing to methodological shortcomings, incomplete presentation, and lack of external validation and model impact studies. Rather than developing yet another similar CVD risk prediction model, in this era of large datasets, future research should focus on externally validating and comparing head-to-head promising CVD risk models that already exist, on tailoring or even combining these models to local settings, and investigating whether these models can be extended by addition of new predictors.

P. Taberlet, L. Fumagalli, A. WUST‐SAUCY et al.

W. Thuiller, S. Lavorel, M. Araújo et al.

W. Rodney

S. Scherhaufer, G. Moates, H. Hartikainen et al.

Approximately 88 Million tonnes (Mt) of food is wasted in the European Union each year and the environmental impacts of these losses throughout the food supply chain are widely recognised. This study illustrates the impacts of food waste in relation to the total food utilised, including the impact from food waste management based on available data at the European level. The impacts are calculated for the Global Warming Potential, the Acidification Potential and the Eutrophication Potential using a bottom-up approach using more than 134 existing LCA studies on nine representative products (apple, tomato, potato, bread, milk, beef, pork, chicken, white fish). Results show that 186 Mt CO2-eq, 1.7 Mt SO2-eq. and 0.7 Mt PO4-eq can be attributed to food waste in Europe. This is 15 to 16% of the total impact of the entire food supply chain. In general, the study confirmed that most of the environmental impacts are derived from the primary production step of the chain. That is why animal-containing food shows most of the food waste related impacts when it is extrapolated to total food waste even if cereals are higher in mass. Nearly three quarters of all food waste-related impacts for Global Warming originate from greenhouse gas emissions during the production step. Emissions by food processing activities contribute 6%, retail and distribution 7%, food consumption, 8% and food disposal, 6% to food waste related impacts. Even though the results are subject to certain data and scenario uncertainties, the study serves as a baseline assessment, based on current food waste data, and can be expanded as more knowledge on the type and amount of food waste becomes available. Nevertheless, the importance of food waste prevention is underlined by the results of this study, as most of the impacts originate from the production step. Through food waste prevention, those impacts can be avoided as less food needs to be produced.

T. Lasanta, J. Arnáez, N. Pascual et al.

Sandra Nolte, G. Liegl, M. Petersen et al.

OBJECTIVE The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 health-related quality of life questionnaire is one of the most widely used cancer-specific health-related quality of life questionnaires worldwide. General population norm data can facilitate the interpretation of QLQ-C30 data obtained from cancer patients. This study aimed at systematically collecting norm data from the general population to develop European QLQ-C30 norm scores and to generate comparable norm data for individual countries in Europe and North America. METHODS We collected QLQ-C30 data from the general population across 11 European Union (EU) countries, Russia, Turkey, Canada and United States (n ≥ 1000/country). Representative samples were stratified by sex and age groups (18-39, 40-49, 50-59, 60-69 and ≥ 70 years). After applying weights based on the United Nations population distribution statistics, we calculated QLQ-C30 domain scores to generate a 'European QLQ-C30 Norm' based on the EU countries. Further, we calculated QLQ-C30 norm scores for all 15 individual countries. RESULTS A total of 15,386 respondents completed the online survey. For the EU sample, most QLQ-C30 domains showed differences by sex/age, with men scoring somewhat better health than women, while age effects varied across domains. Substantially larger differences were seen in inter-country comparisons, with Austrian and Dutch respondents reporting consistently better health compared with British and Polish respondents. CONCLUSIONS This study is the first to systematically collect EORTC QLQ-C30 general population norm data across Europe and North America applying a consistent data collection method across 15 countries. These new norm data facilitate valid intra-country as well as inter-country comparisons and QLQ-C30 score interpretation.

A. Machowska, C. Stålsby Lundborg

The unnecessary use of antibiotics and concomitant rapid growth of antibiotic resistance (ABR) is a widely acknowledged threat to global health, development, and sustainability. While the underlying cause of ABR is undoubtedly the overall volume of antibiotic use in general, irrational antibiotic use, which is influenced by several interrelated factors, is a major contributory factor. Here, we aimed to present and describe selected main drivers of irrational use of antibiotics in Europe. We performed a broad search of the current literature in databases such as PubMed, Google Scholar, Cochrane, as well as various institutional websites (World Health Organization, European Observatory, European Commission) to provide a new perspective on selected drivers of irrational antibiotic use in Europe. We also searched for relevant literature using snowballing, i.e., using reference lists of papers to identify additional papers. In this narrative review, we present that major factors among the general public driving antibiotic resistance are lack of public knowledge and awareness, access to antibiotics without prescription and leftover antibiotics, and knowledge attitude and perception of prescribers and dispensers, inadequate medical training, pharmaceutical promotion, lack of rapid and sufficient diagnostic tests, and patient–doctor interaction as major factors among healthcare providers. We further discuss initiatives that, if taken and implemented, can have an impact on and improve the current situation in Europe.

P. Płudowski, E. Karczmarewicz, M. Bayer et al.

INTRODUCTION Adequate Vitamin D intake and its concentration in serum are important for bone health and calcium-phosphate metabolism as well as for optimal function of many organs and tissues. Documented trends in lifestyle, nutritional habits and physical activity appear to be associated with moderate or severe Vitamin D deficits resulting in health problems. Most epidemiological studies suggest that Vitamin D deficiency is prevalent among Central European populations. Concern about this problem led to the organising of a conference focused on overcoming Vitamin D deficiency. METHODS After reviewing the epidemiological evidence and relevant literature, a Polish multidisciplinary group formulated theses on recommendations for Vitamin D screening and supplementation in the general population. These theses were subsequently sent to Scientific Committee members of the 'Vitamin D - minimum, maximum, optimum' conference for evaluation based on a ten-point scale.With 550 international attendees, the meeting 'Vitamin D - minimum, maximum, optimum' was held on October 19-20, 2012 in Warsaw(Poland). Most recent scientific evidence of both skeletal and non-skeletal effects of Vitamin D as well as the results of panellists' voting were reviewed and discussed during eight plenary sessions and two workshops. RESULTS Based on many polemical discussions, including post-conference networking, the key opinion leaders established ranges of serum 25-hydroxyVitamin D concentration indicating Vitamin D deficiency [< 20 ng/mL (< 50 nmol/L)], suboptimal status [20-30 ng/mL(50-75 nmol/L)], and target concentration for optimal Vitamin D effects [30-50 ng/mL (75-125 nmol/L)]. General practical guidelines regarding supplementation and updated recommendations for prophylactic Vitamin D intakes in Central European neonates, infants, children and adolescents as well as in adults (including recommendations for pregnant and breastfeeding women and the elderly) were developed. CONCLUSIONS Improving the Vitamin D status of children, adolescents, adults and the elderly must be included in the priorities of physicians,healthcare professionals and healthcare regulating bodies. The present paper offers elaborated consensus on supplementation guidance and population strategies for Vitamin D in Central Europe.

A. Bahmanyar, A. Estebsari, D. Ernst

As of March 13, 2020, the director general of the World Health Organization (WHO) considered Europe as the centre of the global COVID-19 outbreak. All countries within Europe had a confirmed case of COVID-19 by March 17. In response to the pandemic, different European countries took different approaches. This paper compares the impact of different containment measures taken by European countries in response to COVID-19 on their electricity consumption profiles. The comparisons are made for Spain, Italy, Belgium and the UK as countries with severe restrictions, and for the Netherlands and Sweden as countries with less restrictive measures. The results show that the consumption profiles reflect the difference in peoples’ activities in different countries using various measures.

M. Segreto, Lucas Principe, Alexandra Desormeaux et al.

Social acceptance has proven to be a significant barrier in the implementation of renewable energy systems (hereinafter “RES”). While a general acceptance of RES is high, low local acceptance has hindered the development of renewable energy projects (hereinafter “REP”). This study assesses the determinants of local and general social acceptance of REP across Europe through a qualitative analysis from 25 case studies of the most significant social drivers and barriers that include all European countries. These case studies contain qualitative and quantitative analyses of the main factors for social acceptance of many representative groups including residents, stakeholders, and experts. Understanding the influences of social acceptance enables us to create strategies that will promote the development of REP by mitigating any public opposition.

C. Eades, D. Cameron, J. Evans

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.

Tobias Heimann, Lara-Sophie Wähling, Tomke Honkomp et al.

Bioenergy with carbon capture and storage (BECCS) is a crucial element in most modelling studies on emission pathways of the Intergovernmental Panel on Climate Change to limit global warming. BECCS can substitute fossil fuels in energy production and reduce CO _2 emissions, while using biomass for energy production can have feedback effects on land use, agricultural and forest products markets, as well as biodiversity and water resources. To assess the former pros and cons of BECCS deployment, interdisciplinary model approaches require detailed estimates of technological information related to BECCS production technologies. Current estimates of the cost structure and capture potential of BECCS vary widely due to the absence of large-scale production. To obtain more precise estimates, a global online expert survey ( N = 32) was conducted including questions on the regional development potential and biomass use of BECCS, as well as the future operating costs, capture potential, and scalability in different application sectors. In general, the experts consider the implementation of BECCS in Europe and North America to be very promising and regard BECCS application in the liquid biofuel industry and thermal power generation as very likely. The results show significant differences depending on whether the experts work in the Global North or the Global South. Thus, the findings underline the importance of including experts from the Global South in discussions on carbon dioxide removal methods. Regarding technical estimates, the operating costs of BECCS in thermal power generation were estimated in the range of 100–200 USD/tCO _2 , while the CO _2 capture potential was estimated to be 50–200 MtCO _2 yr ^−1 by 2030, with cost-efficiency gains of 20% by 2050 due to technological progress. Whereas the individuals’ experts provided more precise estimates, the overall distribution of estimates reflected the wide range of estimates found in the literature. For the cost shares within BECCS, it was difficult to obtain consistent estimates. However, due to very few current alternative estimates, the results are an important step for modelling the production sector of BECCS in interdisciplinary models that analyse cross-dimensional trade-offs and long-term sustainability.

Stefan Kulk, Frederik Zuiderveen Borgesius

In this chapter we discuss the relation between privacy and freedom of expression in Europe. In principle, the two rights have equal weight in Europe - which right prevails depends on the circumstances of a case. We use the Google Spain judgment of the Court of Justice of the European Union, sometimes called the 'right to be forgotten' judgment, to illustrate the difficulties when balancing the two rights. The court decided in Google Spain that people have, under certain conditions, the right to have search results for their name delisted. We discuss how Google and Data Protection Authorities deal with such delisting requests in practice. Delisting requests illustrate that balancing privacy and freedom of expression interests will always remain difficult.

Gjergji Kasneci, Urs Gasser, Thomas F. Hofmann et al.

Europe is at a make-or-break moment in the global AI race, squeezed between the massive venture capital and tech giants in the US and China's scale-oriented, top-down drive. At this tipping point, where the convergence of AI with complementary and synergistic technologies, like quantum computing, biotech, VR/AR, 5G/6G, robotics, advanced materials, and high-performance computing, could upend geopolitical balances, Europe needs to rethink its AI-related strategy. On the heels of the AI Action Summit 2025 in Paris, we present a sharp, doable strategy that builds upon Europe's strengths and closes gaps.

Jukka Ruohonen, Paul Timmers

A new Digital Europe Programme (DEP), a funding instrument for development and innovation, was established in the European Union (EU) in 2021. The paper makes an empirical inquiry into the projects funded through the DEP. According to the results, the projects align well with the DEP's strategic focus on cyber security, artificial intelligence, high-performance computing, innovation hubs, small- and medium-sized enterprises, and education. Most of the projects have received an equal amount of national and EU funding. Although national origins of participating organizations do not explain the amounts of funding granted, there is a rather strong tendency for national organizations to primarily collaborate with other national organizations. Finally, information about the technological domains addressed and the economic sectors involved provides decent explanatory power for statistically explaining the funding amounts granted. With these results and the accompanying discussion, the paper contributes to the timely debate about innovation, technology development, and industrial policy in Europe.

D. Jaffe, B. Rive, T. Denee

BackgroundA patient is considered to suffer from treatment resistant depression (TRD) when consecutive treatment with two products of different pharmacological classes, used for a sufficient length of time at an adequate dose, fail to induce a clinically meaningful effect (inadequate response). The primary aim of the current study was to examine the humanistic and economic burden of TRD in five European countries, France, Germany, Italy, Spain and the United Kingdom, by comparing with non-treatment resistant depression (nTRD) and general population respondents.MethodsThe sample for this retrospective observational study was taken from the 2017 National Health and Wellness Survey conducted in five European countries. Demographic and patient characteristics were examined for TRD patients compared to respondents with nTRD and to the general population using chi-square tests or one-way analysis of variance for categorical or continuous variables, respectively. Generalized linear models were performed to examine group differences after adjusting these estimates for confounders.ResultsA total 52,060 survey respondents were examined, of which 2686 and 622 were considered to have non-treatment resistant and treatment-resistant depression, respectively. Relative to the general population, nTRD and TRD respondents reported significant decrements in health-related quality of life, including lower adjusted mental (− 12.1 vs. -18.1) and physical (− 2.5 vs. -5.4) component scores of the SF-12v2 and increased adjusted relative risk for work (2.2 vs. 2.7) and activity (1.9 vs. 2.5) impairment (all p < 0.001). Additionally, healthcare resource utilization was significantly higher for TRD patients more so than nTRD, compared to the general population, especially for healthcare professional visits (odds ratio nTRD = 5.4; TRD = 15.9, p < 0.001).ConclusionsIn conclusion, TRD patients had significantly lower quality of life, greater work productivity and activity impairment, and increased healthcare resource utilization as compared with nTRD and general population. The study findings suggest an unmet need exists among TRD patients in Europe.