Hasil untuk "Europe (General)"

J. Smolen, R. Landewé, F. Breedveld et al.

Treatment of rheumatoid arthritis (RA) may differ among rheumatologists and currently, clear and consensual international recommendations on RA treatment are not available. In this paper recommendations for the treatment of RA with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs) that also account for strategic algorithms and deal with economic aspects, are described. The recommendations are based on evidence from five systematic literature reviews (SLRs) performed for synthetic DMARDs, biological DMARDs, GCs, treatment strategies and economic issues. The SLR-derived evidence was discussed and summarised as an expert opinion in the course of a Delphi-like process. Levels of evidence, strength of recommendations and levels of agreement were derived. Fifteen recommendations were developed covering an area from general aspects such as remission/low disease activity as treatment aim via the preference for methotrexate monotherapy with or without GCs vis-à-vis combination of synthetic DMARDs to the use of biological agents mainly in patients for whom synthetic DMARDs and tumour necrosis factor inhibitors had failed. Cost effectiveness of the treatments was additionally examined. These recommendations are intended to inform rheumatologists, patients and other stakeholders about a European consensus on the management of RA with DMARDs and GCs as well as strategies to reach optimal outcomes of RA, based on evidence and expert opinion.

J. Jouzel, V. Masson‐Delmotte, O. Cattani et al.

A high-resolution deuterium profile is now available along the entire European Project for Ice Coring in Antarctica Dome C ice core, extending this climate record back to marine isotope stage 20.2, ∼800,000 years ago. Experiments performed with an atmospheric general circulation model including water isotopes support its temperature interpretation. We assessed the general correspondence between Dansgaard-Oeschger events and their smoothed Antarctic counterparts for this Dome C record, which reveals the presence of such features with similar amplitudes during previous glacial periods. We suggest that the interplay between obliquity and precession accounts for the variable intensity of interglacial periods in ice core records.

M. Fall, A. P. Baranowski, C. Fowler et al.

A. Wollenberg, S. Barbarot, T. Bieber et al.

This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus‐based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This second part of the guideline covers antimicrobial therapy, systemic treatment, allergen‐specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions, whereas the first part covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti‐inflammatory therapy, phototherapy and antipruritic therapy. Management of AE must consider the individual clinical variability of the disease. Systemic immunosuppressive treatment with cyclosporine, methotrexate, azathioprine and mycophenolic acid is established option for severe refractory cases, and widely available. Biologicals targeting the T helper 2 pathway such as dupilumab may be a safe and effective, disease‐modifying alternative when available. Oral drugs such as JAK inhibitors and histamine 4 receptor antagonists are in development. Microbial colonization and superinfection may cause disease exacerbation and can require additional antimicrobial treatment. Allergen‐specific immunotherapy with aeroallergens may be considered in selected cases. Psychosomatic counselling is recommended especially in stress‐induced exacerbations. Therapeutic patient education (‘Eczema school’) is recommended for children and adult patients. General measures, basic emollient treatment, bathing, dietary intervention, topical anti‐inflammatory therapy, phototherapy and antipruritic therapy have been addressed in the first part of the guideline.

M. Levy, M. Fink, J. Marshall et al.

L. Hooghe, G. Marks

R. Erikson, J. Goldthorpe

F. Pacini, M. Schlumberger, H. Dralle et al.

M. Daly, J. Rioux, S. Schaffner et al.

M. Antrop

M. Levy, M. Fink, J. Marshall et al.

Andrea Caragliu, Chiara F. Del Bo

Abstract Smart City policies have attracted relevant attention and funding over the last few years. While the time seems now ripe to conclude that such policies have a positive impact on urban economic growth, the picture is much less clear when looking at the microfoundations of this effect. In this paper we look at the urban innovation impact of Smart City policies. In fact, typical Smart City projects imply the involvement not only of major multinational corporations, along with local public authorities, but also of local companies, typically with the aim to translate general technological solutions to the local needs. A new data set collected for these analyses comprises data on Smart City features for 309 European metropolitan areas, Smart City policy intensity, and urban innovation outputs. The latter are proxied by calculating total patent applications to the European Patent Office between 2008 and 2013. Patent counts also include technologically narrower classes, namely high-tech, ICT, and specific Smart City technologies patent applications. Propensity Score Matching estimates suggest that cities engaging in Smart City policies above the EU average also tend to patent more intensively. This effect is stronger for high-tech patents, while decreases for more narrowly defined technological classes. This last result suggests possible technological spillovers from technologies directly involved in Smart City policies.

J. Kooij, D. Bijlenga, L. Salerno et al.

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness. Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated. Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated? Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.

Alessandro Cassini, D. Plachouras, T. Eckmanns et al.

Background Estimating the burden of healthcare-associated infections (HAIs) compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. Based on the methodology of the Burden of Communicable Diseases in Europe (BCoDE) project and 2011–2012 data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals, we estimated the burden of six common HAIs. Methods and Findings The included HAIs were healthcare-associated pneumonia (HAP), healthcare-associated urinary tract infection (HA UTI), surgical site infection (SSI), healthcare-associated Clostridium difficile infection (HA CDI), healthcare-associated neonatal sepsis, and healthcare-associated primary bloodstream infection (HA primary BSI). The burden of these HAIs was measured in disability-adjusted life years (DALYs). Evidence relating to the disease progression pathway of each type of HAI was collected through systematic literature reviews, in order to estimate the risks attributable to HAIs. For each of the six HAIs, gender and age group prevalence from the ECDC PPS was converted into incidence rates by applying the Rhame and Sudderth formula. We adjusted for reduced life expectancy within the hospital population using three severity groups based on McCabe score data from the ECDC PPS. We estimated that 2,609,911 new cases of HAI occur every year in the European Union and European Economic Area (EU/EEA). The cumulative burden of the six HAIs was estimated at 501 DALYs per 100,000 general population each year in EU/EEA. HAP and HA primary BSI were associated with the highest burden and represented more than 60% of the total burden, with 169 and 145 DALYs per 100,000 total population, respectively. HA UTI, SSI, HA CDI, and HA primary BSI ranked as the third to sixth syndromes in terms of burden of disease. HAP and HA primary BSI were associated with the highest burden because of their high severity. The cumulative burden of the six HAIs was higher than the total burden of all other 32 communicable diseases included in the BCoDE 2009–2013 study. The main limitations of the study are the variability in the parameter estimates, in particular the disease models’ case fatalities, and the use of the Rhame and Sudderth formula for estimating incident number of cases from prevalence data. Conclusions We estimated the EU/EEA burden of HAIs in DALYs in 2011–2012 using a transparent and evidence-based approach that allows for combining estimates of morbidity and of mortality in order to compare with other diseases and to inform a comprehensive ranking suitable for prioritization. Our results highlight the high burden of HAIs and the need for increased efforts for their prevention and control. Furthermore, our model should allow for estimations of the potential benefit of preventive measures on the burden of HAIs in the EU/EEA.

S. Sans, H. Kesteloot, D. Kromhout

Jagad Aditya Dewantara, Dasim Budimansyah, Wibowo Heru Prasetiyo et al.

This paper examines the civic identity of the Dayak people in the West Kalimantan border region within the context of ethnic transnationalism, emphasizing the role of custom and cross-border mobility. Recognizing that Dayak communities have historically lived beyond the boundaries of modern states, the study conceptualizes citizenship as a lived social experience that does not always align with nation-state logic. Using ethnographic methods, the research explores how Dayak people interpret citizenship through everyday practices, kinship relations, and cross-border interactions. The findings show that citizenship is understood situationally and pragmatically, particularly in relation to administrative needs and access to state services, while ethnic and customary identities remain the primary basis of social loyalty. Custom functions as a value framework regulating community membership, social relations, and attachment to ancestral lands across borders. Continuous mobility sustains a transnational social space where borders are negotiated administrative structures rather than rigid social boundaries. The study highlights the layered and dynamic nature of border citizenship and contributes to scholarship on indigenous transnationalism.

Leonardo Varasano

Beginning in the 1980s, the mediatization of soccer also manifested itself through the phenomenon of fanzines, instruments of information, but even more so of counter-information, dissonant and free voices. In this panorama, an original case study is that of the fanzine “Brigata Ultrà,” a folio of the eponymous group of supporters from Perugia’s north curve between 1994 and 2008. The “Brigata” has a strong territorial identity tied to a specific area of the city and with a political orientation dissonant with that of the Perugia curve: it is a “black” (i. e. right wing) group in a “red” curve (i. e. left wing). This composite identity takes on visible forms and manners that attract national attention. The group travels for years on away trips with a black bus recognizable by an eagle, a tricolor and a Grifo (the symbol of the city). Added to this is the frequent practice of physically following the Italian national team’s matches as well. The fanzine becomes the “voice” of the “Brigata” by proposing and nurturing, around soccer, multiple identities: that of the home neighborhoods, the one of the city, the one of the national, and the one of the politically right-wing oriented.

Silvana Espiga Dorado, María Laura Osta Vázquez, Facundo Álvarez Constantín

Esta entrevista realizada a la dra. Susana Sosenski trata sobre las reflexiones, los desafíos y los obstáculos que una investigadora de la infancia en América Latina puede enfrentar. Las interrogantes que ella misma se ha planteado desde su realidad han guiado toda su producción historiográfica, que nutre a historiadoras/es de América Latina y el mundo. Susana Sosenski, fundadora de la Red de Estudios de Historia de las Infancias en América Latina, nos cuenta cómo y cuándo fue fundada la REHIAL y los objetivos que ha perseguido desde sus inicios.

Martha Belén Zúñiga Contreras

El objetivo del artículo consiste en presentar un análisis histórico de la labor diplomática de Girolamo Prigione en México y las redes que consolidó para, por un lado, convertirse en el interlocutor privilegiado con el gobierno (junto con un selecto grupo de obispos que configuraron el Club de Roma) y, por otro, para conducir el destino de la Iglesia en el país. Para ello, se abordará su trabajo desde la perspectiva de los grupos inclinados a la Teología de la Liberación que vieron en él una labor más política que pastoral. Este es el elemento original, pues se reconstruyen los hechos a partir de la experiencia de este sector del episcopado mexicano y se retoman las tensiones que el protagonismo del Club de Roma generó en el resto de la Conferencia del Episcopado, aspecto poco abordado en la historiografía existente. Para cumplir con dicho propósito, se revisaron artículos publicados en la prensa nacional de la época, mismos que permiten conocer la postura de los actores al ocurrir los hechos; se realizaron entrevistas a personajes involucrados en el proceso; se consultaron documentos inéditos del Archivo Histórico del Arzobispado de México y se incluyó bibliografía especializada sobre el tema

V. A. Fedotova

The study aims to identify peculiarities of sociocultural adaptation (factors, coping strategies and anticipatory competence) of students from India, China and Arab countries. The research is based on the data obtained from the first-, second- and third-year students from India (73 respondents), China (45 respondents), Arab countries (64 respondents). The “Russian language proficiency” factor shows more significance for students from India and China, compared to students from Arab countries. Students from China, India and Arab countries tend to start and maintain relationships, to participate in academic activities, to have hobbies and interests and interact with other students. The prosocial coping strategy is predominant for Arab, Indian and Chinese students, regardless of their culture of origin, which proves  universality of the strategy. Representatives of a polychronic culture (students from Arab countries and India) lack temporal anticipatory competence,with Arab students showing the lowest value of this parameter. Chinese  students differ from representatives of a polyactive culture (Arab students) or a reactive-polyactive culture (Indian students) as they can hardly predict how a person they know would act in a certain situation.