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PubMed2005

Effectiveness of a psychoeducational intervention for families of patients with schizophrenia: preliminary results of a study funded by the European Commission.

In spite of their proven efficacy, psychoeducational interventions for families of patients with schizophrenia are not being commonly applied in clinical practice. In this report, we present the preliminary results of a one-year follow-up study on the implementation and effectiveness of a psychoeducational family intervention in six European countries. Forty-eight professionals were involved in the study and provided the intervention for one year to 55 families of patients with schizophrenia. During the implementation period, the professionals reported significant organisational difficulties in the provision of the intervention, but acknowledged an improvement of their relationships with users and their families. At follow-up assessment, statistically significant improvements were found in patients' symptoms and social functioning as well as in relatives' burden, coping strategies and social resources.

Journal Article↗

PubMed1997

European Commission Biomed 2 project: standards of care for children with cleft lip and palate (Eurocleft 1996-1999).

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Child↗

PubMed1999

Household budget survey nutritional data in relation to mortality from coronary heart disease, colorectal cancer and female breast cancer in European countries. DAFNE I and II projects of the European Commission. Data Food Networking.

OBJECTIVE: We have undertaken a study to examine whether Household Budget Survey (HBS)-derived nutritional patterns are related to mortality from diseases with strong nutritional components, namely coronary heart disease, colorectal cancer and cancer of the female breast. DESIGN: Ecological correlation study. In the context of the Data Food Networking projects of the European Union, raw data from the national HBS of 10 European countries were provided. For each of the 10 participating countries, daily food availability per capita around 1990 was calculated. Individual foods were aggregated into 12 major food groups that were linked with the diseases under consideration. Mortality data were available from a World Health Organisation database. We have used a composite score to summarise the postulated influence of diet. SETTING: Ten European countries circa 1990. RESULTS: The correlation coefficients between the composite score and the age-adjusted mortality from each of the studied diseases were: + 0.51 (P approximately 0.14) for colorectal cancer; +0.72 (P approximately 0.02) for female breast cancer; and +0.60 (P approximately 0.07) for coronary heart disease, after adjustment for tobacco smoking. CONCLUSIONS: We conclude that dietary information from HBS is sufficiently reliable to reveal correlations with mortality rates from chronic diseases with fairly strong nutritional roots. HBS data could be used, with little cost, for monitoring secular trends in dietary patterns with a view to their health implications.

Animals↗

PubMed2000

Causes of inconsistency in diagnosing and classifying intraductal proliferations of the breast. European Commission Working Group on Breast Screening Pathology.

It is now widely recognised that classifying ductal carcinoma in situ (DCIS) of the breast and diagnosing atypical ductal hyperplasia are associated with significant interobserver variation. Two possible reasons for this inconsistency are differences in the interpretation of specified histological features and field selection where morphology is heterogeneous. In order to investigate the relative contribution of these two factors to inconsistent interpretation of intraductal proliferations, histological sections of 32 lesions were sent to 23 European pathologists followed 3 years later by images of small parts of these sections. Kappa statistics for diagnosing hyperplasia of usual type, atypical ductal hyperplasia and ductal carcinoma in situ were 0.54, 0.35 and 0.78 for sections and 0.47, 0.29 and 0.78 for images, respectively, showing that most of the inconsistency is due to differences in morphological interpretation. Improvements can thus be expected only if diagnostic criteria or methodology are changed. In contrast, kappa for classifying DCIS by growth pattern was very low at 0.23 for sections and better at 0.47 for images, reflecting the widely recognised variation in the growth pattern of DCIS. Higher kappa statistics were obtained when any mention of an individual growth pattern was included in that category, thus allowing multiple categories per case; but kappa was still higher for images than sections. Classifying DCIS by nuclear grade gave kappa values of 0.36 for sections and 0.49 for images, indicating that intralesional heterogeneity has hitherto been underestimated as a cause of inconsistency in classifying DCIS by this method. More rigorous assessment of the proportions of the different nuclear grades present could lead to an improvement in consistency.

Breast↗

PubMed1998

Consistency achieved by 23 European pathologists in categorizing ductal carcinoma in situ of the breast using five classifications. European Commission Working Group on Breast Screening Pathology.

The increased detection of ductal carcinoma in situ (DCIS) by mammographic screening, the greater use of breast-conserving surgery, and the recognition that certain histological subtypes are associated with a greater risk of local recurrence has led to the formulation of several new classifications of DCIS in recent years. There are, however, no data concerning the degree of consistency with which these schemes can be applied by reasonable numbers of pathologists. Thirty-three cases of DCIS were thus examined by a working group of 23 European pathologists who categorized them using five recently published classifications: (1) that of the European Pathologists' Working Group based on differentiation (a combination of nuclear grade and cell polarization) with categories of poorly, intermediately, and well differentiated; (2) one based entirely on nuclear grade with categories of high, intermediate, and low, currently in use in the UK national and EC-funded breast screening programs; (3) the same classification in which only two categories, high nuclear grade and other, were used; (4) the Van Nuys system in which lesions are divided into high grade, non-high grade with necrosis and non-high grade without necrosis; and (5) a two-category classification based entirely on the presence or absence of comedo necrosis. Of the three systems with three categories, Van Nuys gave the highest overall kappa statistic of 0.42. Others gave similar values of 0.37 and 0.35 showing that assessing cell polarization in addition to nuclear grade neither improves nor worsens consistency. In all three systems, the middle category was associated with the lowest value for kappa. Of the two systems with two categories, that based on nuclear grade gave the highest overall kappa of 0.46 and that based on comedo necrosis the lowest of 0.34. The most robust histological features were thus high- and low-grade nuclei and necrosis as long as the latter did not involve the recognition of a comedo growth pattern. These values probably represent the maximum achievable, at least by reasonable numbers of pathologists in everyday practice. They are better than those previously reported for classification based entirely on architecture, but further improvement is needed.

Breast Neoplasms↗

PubMed2000

Regional and international integrated telemedicine network for organ transplant (HC 4028 & IN 4028 European Commission DGXIII).

A substantial portion of future medical practice will depend greatly on improved collaboration between the providers throughout the healthcare sector, and effective sharing of data and expertise by different healthcare professionals. In organ transplant it is a rule, donor organs are matched to recipients via national or multinational organ-sharing organizations. Only through close co-operation between transplant surgeons, immunologists, nephrologists, pathologists, radiologists and other physicians could one increase the efficiency of organ transplantation. Information technology (IT) has become an inevitable and inherent part of transplantation medicine. The RETRANSPLANT project interfaces and integrates IT from the European Union Fourth Framework projects to support the development of regional organ transplant information networks in Central Europe.

Bone Marrow Transplantation↗

PubMed2000