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At least 19 recordsLinked to original sources
PubMed1993

Action plan for a tobacco-free Europe: implementation in central and eastern Europe, 1993-94. WHO Regional Office for Europe.

Major political and social changes in central and eastern European (CEE) countries offer new opportunities and challenges in tobacco control. Action against tobacco in CEE countries is part of an overall European strategy, the action plan for a tobacco-free Europe. Several CEE countries have voiced their concern about the deterioration of tobacco control and about the entry of the international tobacco industry. In response, the Regional Office has set up a framework for an international task force. The core of the task force consists of the EURO staff and a special consultant. Several European countries and organizations have already expressed their willingness to joint the task force by seconding an expert to participate in the country missions and consensus conferences. This paper describes particular steps to implement the action plan in central and eastern Europe. It outlines priority action to be carried out by the CEE countries themselves and describes possibilities for assistance by all European countries. A key role is assigned to a European alliance on tobacco or health to create psychological and material prerequisites for action as well as act in an advisory role. Some of the projects are already underway, but they can be considerably strengthened by extra resources and support. Some of the projects are possible only with new resources. The project proposals are classified according to the six areas of the new action plan but presented in a different order. This paper sets out a range of activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Environmental Health↗
PubMed2004

Lower incidence rates but thicker melanomas in Eastern Europe before 1992: a comparison with Western Europe.

The objective of this study was to investigate the epidemiology of melanoma across Europe with regard to Breslow thickness and body-site distribution. Incidence data from Cancer Incidence in 5 Continents and the EUROCARE-melanoma database were used: 28?117 melanoma cases from 20 cancer registries in 12 European countries, diagnosed between 1978 and 1992. Regression analysis and general linear modelling were used to analyse the data. Melanomas in Eastern Europe were on average 1.4 mm thicker (P<0.05) than in Western Europe and appeared more often on the trunk. From 1978 to 1992, their Breslow thickness had decreased in Western but not Eastern Europe. There was a latitude gradient in incidence, with highest rates in southern regions in Eastern Europe and an inverse gradient in Western Europe, with highest rates in the North. Mortality:incidence ratios were less favourable in southern parts across Europe, especially in Eastern Europe. If Eastern European populations copy the sunbathing behaviour of the West it is likely that in the near future a higher melanoma incidence can be expected there.

Adult↗
PubMed2006

Across Siberia and over Europe: Phylogenetic relationships of the freshwater fish genus Rhodeus in Europe and the phylogenetic position of R. sericeus from the River Amur.

We present the phylogenetic relationships of the freshwater fish genus Rhodeus from 45 localities in Europe and three localities in the Amur basin using the mitochondrial cytochrome b sequence. The study aims to (1) test the colonisation history between Europe and East Asia and (2) to reconstruct the evolutionary history of Rhodeus in Europe. Our analyses revealed five monophyletic clades which correspond to four species: R. sericeus in the Amur basin, R. meridionalis in the River Vardar, R. colchicus in western Caucasus and two sister lineages in most of Europe which together represent R. amarus. The reconstructed colonisation scenario assumes a continuous distribution of Rhodeus from Europe through Siberia until East Asia during Pliocene, depletion of the Siberian population in late Pliocene, isolation of the population in River Vardar during early Pleistocene, refuges during late Pleistocene glaciations in the Danubian basin, in the lowlands of western Black Sea and in western Caucasus Mountains and a post-glacial expansion from the Danubian refuge towards western Europe and from the Black Sea refuge across Eastern Europe.

Animals↗
PubMed2003

Changing epidemiology of malignant cutaneous melanoma in Europe 1953-1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia.

We analyzed time trends in incidence of and mortality from malignant cutaneous melanoma in European populations since 1953. Data were extracted from the EUROCIM database of incidence data from 165 cancer registries. Mortality data were derived from the WHO database. During the 1990s, incidence rates were by far highest in northern and western Europe, whereas mortality was higher in males in eastern and southern Europe. Melanoma rates have been rising steadily, albeit with substantial geographic variation. In northern Europe, a deceleration in these trends occurred recently in persons aged under 70. Joinpoint analyses indicated that changes in these trends took place in the early 1980s. In western Europe, mortality rates have also recently leveled off [estimated annual percentage change (EAPC) from -13.6% (n.s.) to 3.3%], whereas in eastern and southern Europe both incidence and mortality rates are still increasing [incidence EAPCs 2.3-8.9%, mortality EAPCs -1.8% (n.s.) to 7.2%]. Models including the effects of age, period and birth cohort were required to adequately describe the rising incidence trends in most European populations, with a few exceptions. Time trends in mortality were adequately summarized on fitting either an age-cohort model (with the leveling off of rates starting in birth cohorts between 1930 and 1940) or an age-period-cohort model. The most plausible explanations for the deceleration or decline in the incidence and mortality trends in recent years in northern (and to a lesser extent western) Europe are earlier detection and more frequent excision of pigmented lesions and a growing public awareness of the dangers of excessive sunbathing.

Adult↗
PubMed2005

Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1).

BACKGROUND: This paper is a part of the work of the group that carried out the report "The state of the mental health in Europe" (European Commission, DG Health and Consumer Protection, 2004) and deals with the mental health issues related to the migration in Europe. METHODS: The paper tries to describe the social, demographical and political context of the emigration in Europe and tries to indicate the needs and (mental) health problems of immigrants. A review of the literature concerning mental health risk in immigrant is also carried out. The work also faces the problem of the health policy toward immigrants and the access to health care services in Europe. RESULTS: Migration during the 1990s has been high and characterised by new migrations. Some countries in Europe, that have been traditionally exporters of migrants have shifted to become importers. Migration has been a key force in the demographic changes of the European population. The policy of closed borders do not stop migration, but rather seems to set up a new underclass of so-called "illegals" who are suppressed and highly exploited. In 2000 there were also 392,200 asylum applications. The reviewed literature among mental health risk in some immigrant groups in Europe concerns: 1) highest rate of schizophrenia; suicide; alcohol and drug abuse; access of psychiatric facilities; risk of anxiety and depression; mental health of EU immigrants once they returned to their country; early EU immigrants in today disadvantaged countries; refugees and mental health. Due to the different condition of migration concerning variables as: motivation to migrations (e.g. settler, refugees, gastarbeiters); distance for the host culture; ability to develop mediating structures; legal residential status it is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. In this sense, psychosocial studies should be undertaken to identify those factors which may under given conditions, imply an increased risk of psychiatric disorders and influence seeking for psychiatric care. COMMENTS AND REMARKS: Despite in the migrants some vulnerable groups were identified with respect to health problems, in many European countries there are migrants who fall outside the existing health and social services, something which is particularly true for asylum seekers and undocumented immigrants. In order to address these deficiencies, it is necessary to provide with an adequate financing and a continuity of the grants for research into the multicultural health demand. Finally, there is to highlight the importance of adopting an integrated approach to mental health care that moves away from psychiatric care only.

Journal Article↗
PubMed1997

Fertility and contraception in Europe: the case of low fertility in southern Europe.

Demographic trends in Europe can be summarized in terms of a declining proportion of its population in the world total, low fertility, and a slow population growth. Fertility in Western Europe was already below the replacement level in 1970-75 and has remained low. Fertility has substantially declined in Eastern and Southern Europe, with Italy and Spain recording one of the lowest levels (1.2 children per woman) in 1994. Some explanations of the dramatic fertility decline in Southern Europe are: (1) The emancipation of women and their increased participation in the labor force; (2) Economic aspects such as costs for child care and education; and (3) The couple's motivation for low fertility because of the expanded choices for travel and leisure and their concerns for improving their standard of living. Social pressures on childbearing outside marriage remain quite strong; cohabitation and extramarital births is Southern Europe are not as prevalent as in other European regions and there is a trend toward delaying the birth of the first child rather than foregoing childbearing.

Adult↗
PubMed2002

Multicentre assessment of linezolid antimicrobial activity and spectrum in Europe: report from the Zyvox antimicrobial potency study (ZAPS-Europe).

OBJECTIVE: To evaluate the in vitro spectrum and activity of linezolid, a recent oxazolidinone, according to well-controlled surveillance data from 42 medical centers in 13 countries throughout Europe. METHODS: Participants tested the susceptibility of 125 clinical strains of enterococcal and staphylococcal species against 13 drugs using reference broth microdilution trays or the standardized disk diffusion method of the National Committee for Clinical Laboratory Standards (NCCLS). Streptococcal species (n = 25 at each center) were tested against six drugs using E test (AB BIODISK, Solna, Sweden). Quality assurance testing was conducted using NCCLS-recommended strains and verification of resistance to linezolid and other selected agents was performed by retesting strains at the regional (Europe) and international (USA) monitor sites. RESULTS: A total of 5598 strains from throughout Europe (91% compliance) were tested. Vancomycin resistance was reported in only 0.6 and 3.0% of Enterococcus faecalis and E. faecium, respectively. Penicillin resistance occurred in 25.1% of Streptococcus pneumoniae; 4.9% at the high-level (> or =2 mg/L). The MIC90 for linezolid was 1 mg/L for streptococci and 2 mg/L for enterococci and staphylococci. Using the US FDA- and EUCAST-recommended susceptible breakpoints for linezolid, there were no confirmed reports of linezolid resistance [minimum inhibitory concentration (MIC), > or =8 mg/L]. The distribution of linezolid MIC values was unimodal and varied between 0.25 and 1 mg/L for streptococci (>90% of isolates), and between 1 and 2 mg/L for staphylococci (>90%) and enterococci (>95%). There were no differences in linezolid susceptibility in the vancomycin-, oxacillin-, or penicillin-resistant subsets of strains when compared to susceptible organism populations. CONCLUSIONS: Compared to the North American component of this study, there was substantially less vancomycin resistance among E. faecium isolates (Europe 3.0% vs. North America 63.4%). While the occurrence of penicillin-resistant S. pneumoniae in Europe and North America was similar (25.1% vs. 29.7%), the recovery of high-level penicillin-resistant strains was nearly three-fold higher in North America (4.9% vs. 13.2%). Only linezolid was universally active against all the tested Gram-positive isolates at </=4 mg/L.

Acetamides↗
PubMed1994

Comparison of serological and DNA HLA-DR typing results for transplantation in Western Europe, Eastern Europe, North America and South America.

In a previous study, DNA typing revealed that 25% of serological HLA-DR typings of kidney transplants were incorrect. In the current study, we analyzed whether this error rate had improved in recent years, and whether there were differences according to geographical region. From 1988 to 1991 the error rate of serological typing improved slightly in Western Europe from 19% to 16%, and in North America, from 21% to 16%. In Eastern Europe, the error rate decreased from 49% to 33% in 1991, whereas the rate remained high in South America at 60% in 1988 and 72% in 1991. The high error rates in South America and Eastern Europe reflected a lack of good quality serological typing reagents. The 16% typing errors in Western Europe and North America demonstrated the current limit of serological techniques for cadaver donor typing and underlined the need for prospective DNA typing.

DNA↗
PubMed1996

Epidemiology of AIDS-related Kaposi's sarcoma in Europe over 10 years. AIDS in Europe Study Group.

OBJECTIVES: To determine the incidence and risk factors associated with Kaposi's sarcoma (KS) occurrence as an AIDS-defining condition or after the diagnosis of AIDS. DESIGN: Multicentre retrospective cohort study of AIDS in Europe database from 52 clinical centres in 17 European countries. METHODS: Patients' charts (n = 6546) were reviewed and collected in the database of the AIDS in Europe Study Group from 1979 to 1989. At the time of AIDS diagnosis 1394 patients had KS, whereas an additional 525 others developed KS after AIDS diagnosis. Univariate analysis and development of multivariate models determined factors associated with KS occurrence. RESULTS: Frequency of KS as an AIDS-defining condition significantly declined over time (P < 0.0001). In our cohort of patients, homo-/bisexual men from central Europe with CD4 cell counts > 150 x 10(6)/l were statistically more likely to develop KS at the time of AIDS diagnosis (P < 0.0001). For patients with an AIDS diagnosis other than KS, the probability of developing KS during the follow-up was 10 and 24% after 12 and 36 months, respectively. Variables significantly associated with a further KS development were transmission group, central European residence, previous herpes simplex infection other than ulcers, and low CD4 cells (< 150 x 10(6)/l). Previous zidovudine therapy had no influence on KS appearance. For patients who developed KS subsequent to AIDS diagnosis, there was no significant decline of the incidence over the 10-year time period. CONCLUSIONS: This large cohort study clearly shows that demographic data such as sex, transmission group and region of Europe have a major influence on KS development. It also suggests that KS as an AIDS-defining disease occurs earlier in the course of the chronic HIV infection than other opportunistic diseases. Reasons for geographical variations and its declining frequency as an initial AIDS diagnosis remain undetermined.

AIDS-Related Opportunistic Infections↗
PubMed2001

Health behaviour, risk awareness and emotional well-being in students from Eastern Europe and Western Europe.

Life expectancy and other indices of health have deteriorated markedly in the former socialist countries of Eastern Europe over recent decades. The possible roles of lifestyles, knowledge about health and behaviour, emotional wellbeing and perceptions of control were assessed in a cross-sectional survey of young adults of similar educational status in Eastern and Western Europe. As part of the European Health and Behaviour Survey, data were collected in 1989-1991 from 4170 university students aged 18-30 years from Austria, Belgium, the Federal Republic of Germany, the Netherlands and Switzerland, and from 2293 students from the German Democratic Republic, Hungary and Poland. Measures were obtained of health behaviours, awareness of the role of lifestyle factors in health, depression, social support, health locus of control, and the value placed on health. After adjustment for age and sex, East European students had less healthy lifestyles than Western Europeans according to a composite index of 11 health behaviours, with significant differences for seven activities: regular exercise, drinking alcohol, avoiding dietary fat, eating fibre, adding salt to food, wearing a seat-belt, and using sunscreen protection. East European students were less likely to be aware of the relationship between lifestyle factors (smoking, exercise, fat and salt consumption) and cardiovascular disease risk. In addition, they were more depressed (adjusted odds of elevated scores on the Beck Depression Inventory of 2.46, 95% C.I. 1.95-3.09), reported lower social support, and had higher beliefs in the "chance" and "powerful others" locus of control. Internal locus of control levels did not differ across regions, and Eastern Europeans placed a higher valuation on their health. Unhealthy lifestyles associated with lack of information about health and behaviour, greater beliefs in uncontrollable influences, and diminished emotional well-being, may contribute to poor health status in Eastern Europe.

Adolescent↗
PubMedDate not supplied

The ethics of resuscitation; differences between Europe and the USA--Europe should not adopt American guidelines without debate.

There are differences between Europe and the USA in the style of medical decision-making for patients who are critically ill or requiring CPR. These differences are both legal and philosophical. They concern principally the degree of influence the patient and next of kin should have on critical medical decisions. Currently American physicians transfer more of the decision-making to patients and relatives than do their European counterparts. The current state of the art in cardio-pulmonary resuscitation (CPR) from cardiac arrest occurring out-of-hospital requires public education programmes. These heighten public awareness of CPR-related questions. There has been a wide acceptance in Europe of the American guidelines for CPR. Cultural and legal differences, however, should encourage the acceptance of specific European guidelines. The author believes that it is important to introduce in the European CPR programmes discussions on the ethical dilemmas that may occur. This may help to conserve the relatively high level of public trust that facilitates the patient-doctor relationship in Europe, compared with the USA. Arguments are also put forward for a heightened sensitivity in the European medical profession concerning communication with the patients and their next of kin and with the mass media, in view of the increasing public sophistication and interest that the citizen CPR programmes are generating.

Cultural Diversity↗
PubMed1999

Antimicrobial activity of gatifloxacin (AM-1155, CG5501), and four other fluoroquinolones tested against 2,284 recent clinical strains of Streptococcus pneumoniae from Europe, Latin America, Canada, and the United States. The SENTRY Antimicrobial Surveillance Group (Americas and Europe).

The newer fluoroquinolones generally have greater potency against Gram-positive cocci including Streptococcus pneumoniae. In this study, we report the activity of gatifloxacin (formerly AM-1155 or CG5501) compared with penicillin, erythromycin, and four other peer drugs, tested against 2284 strains isolated in North America (Canada and United States), Latin America (six nations), and Europe in 1997. Reference broth microdilution methods were used and results were interpreted by consensus standards. Gatifloxacin demonstrated uniform potency against pneumococci across all monitored geographic areas (MIC90, 0.5 microgram/mL; > or = 99.6% of strains inhibited at < or = 1 microgram/mL). This activity was comparable to trovafloxacin (MIC90, 0.5 microgram/mL) and sparfloxacin (MIC90, 0.5 microgram/mL) and two- to four-fold greater than that of ciprofloxacin or levofloxacin. The most resistant strains to the fluoroquinolones had mutations in both par C (Ser 79-->Phe) and gyr A (Ser83-->Lys or Phe). Penicillin resistance (MIC, > or = 0.12 microgram/mL) rates varied from 27.6% in Europe to 55.7% in Latin America. Macrolide resistance was greatest in Europe and the United States. Gatifloxacin appears to be a promising new fluoroquinolone for clinical use in respiratory tract infections commonly caused by S. pneumoniae.

Anti-Infective Agents↗
PubMedDate not supplied

Economic Commission for Europe inventory of transboundary ground water in Europe.

In Europe, a long history of cooperation over transboundary rivers--most notably the Rhine and Danube rivers--exists. To help foster cooperation and communication vis-à-vis transboundary ground water, the United Nations Economic Commission for Europe (UNECE), as part of its ground water program, conducted a survey on transboundary aquifers in Europe. The survey produced 25 responses from 37 countries and identified 89 transboundary aquifers. Respondents reported on the degree of ground water use within their own boundaries, transboundary aspects (agreements, joint commissions, etc.) of ground water, and transboundary aquifers themselves. The inventory proved useful, but a number of problems were identified: different map scales and symbols, difficulty in identifying transboundary aquifers, inconsistent labeling of aquifers, and data discrepancies. The UNECE ground water program also drafted guidelines for monitoring and assessment of transboundary ground water. These guidelines are not legally binding but have been adopted by 25 countries, deal mainly with monitoring and assessment, and are being implemented through a number of pilot projects. Other organizations-the United Nations Scientific, Educational and Cultural Organization, the Food and Agriculture Organization, the International Association of Hydrogeologists, and the European Union--are all supporting the investigation of transboundary aquifers in an effort to facilitate data sharing and coordinated management of these valuable resources.

Conservation of Natural Resources↗
PubMed2006

Overview of brachytherapy resources in Europe: a survey of patterns of care study for brachytherapy in Europe.

BACKGROUND AND PURPOSE: The Patterns of Care for Brachytherapy in Europe (PCBE) study is aimed at establishing a detailed information system on brachytherapy throughout Europe. MATERIALS AND METHODS: The questionnaire was web-based and the analysis used data from each radiotherapy department with brachytherapy. There were three groups: Group I with 19 countries (15 initial European Community (EC) countries plus Iceland, Monaco, Norway and Switzerland -EC+4-), Group II with 10 countries (New European Community countries -NEC-) and Group III with 14 countries (Other European Countries -OEC-). RESULTS: In the European area there are 36 of 43 countries (85%) which achieved data collection from at least 50% of centres, and were included in the analysis. The tumour site that had the largest number of treated patients was gynaecological tumours. Several variations have been found in the mean number of patients treated per consultant radiation oncologist and physicist; and in the proportion of brachytherapy patients with gynaecology, prostate and breast tumours, by country and by European area. The provided data showed that the average number of brachytherapy patients per centre increased by 10% between 1997 and 2002. CONCLUSIONS: A European wide evaluation of brachytherapy practice using a web-based questionnaire is feasible and that there is considerable variation in both patterns of practice and available resources.

Brachytherapy↗
PubMed1996

Epidemiology of AIDS dementia complex in Europe. AIDS in Europe Study Group.

The aim of the study was to describe the epidemiology of AIDS dementia complex (ADC) in Europe and to assess the possible role of zidovudine therapy in preventing or delaying its occurrence. We used an inception cohort, with data collected retrospectively from patients' clinical records from 52 clinical centers in 17 countries across Europe. The subjects were 6,548 adult people with AIDS consecutively diagnosed from 1979 to 1989. The main outcome measures were codiagnosis of ADC at the time of AIDS diagnosis and ADC-free time after AIDS diagnosis. ADC was reported in 295 patients (4.5%) at the time of AIDS diagnosis and during follow-up in a further 402 of the 5,160 patients (7.8%) who were diagnosed with AIDS based on diseases other than ADC. Whether at the time of AIDS diagnosis or later, the occurrence of ADC was significantly associated with age, transmission category, and CD4+ cell counts. The risk was greater in older patients (14 and 19% greater, at AIDS diagnosis and after, respectively, for a 5-year difference in age), in i.v. drug users than in homosexual and bisexual men (89 and 60% greater, at AIDS diagnosis and after, respectively), and for people with lower CD4+ cell counts (14 and 30% greater for a reduction of 1 on the natural log scale). Risk was almost double for women than for men. A significant reduction, of approximately 40%, was found in the risk of developing ADC after AIDS diagnosis for patients receiving zidovudine therapy, but this effect was present only during the first 18 months of treatment, irrespective of whether treatment began before or after AIDS diagnosis. In conclusion, an increase in the risk of developing ADC either at the time of AIDS diagnosis or thereafter is associated with increasing age, i.v. drug use, and decreased CD4+ cell count. Women tend to have a higher risk of ADC at the time of AIDS diagnosis. Zidovudine therapy appears to have a definite, but time-limited, effect of protecting patients against ADC development after AIDS diagnosis.

AIDS Dementia Complex↗
PubMed2004

Political leadership in Europe--an assessment of the impact of the 2004 EU Accession round on nursing in Europe.

BACKGROUND: The accession of 12 countries to the European Union necessitated mechanisms to be put in place to offer support to the professions to comply with Directives applying to their training. The author led missions to these countries on behalf of the European Union Commission. This paper reports on the issues arising from the accession process in terms of the political leadership of nursing in Central Europe. It places the current developments in historic and geo-political contexts. KEY ISSUES: The development of nurse leadership is central to the response of the profession to this. Challenges emerging from the history of the region, socio-cultural norms, and current political maturity are addressed. CONCLUSIONS: The need for nurses in both Western and Central Europe to work together is emphasized. The future challenges to be faced as further accession rounds occur are also identified.

Europe↗
PubMed1999

Legal and ethical perspectives on delivery of reproductive and sexual health services in the countries of eastern Europe and the CIS (countries with economies in transition, Europe).

International human rights conferences have repeatedly declared that reproductive and sexual health and choice are human rights entitled to protection and respect. This is no less true in the countries of Eastern Europe and the New Independent States (NIS). It was widely believed that the dissolution of the former Soviet Union and of Communist rule in Eastern Europe would lead to conditions of greater freedom, health and prosperity and to a time of greater respect for reproductive health and rights of choice. In fact, that has not happened; in some respects, the situation in these countries is now worse than before. This article examines the current state of reproductive and sexual health in these countries and several of the reasons why conditions, generally speaking, have not improved since the transition. It closes by identifying some suggestions for positive change and some resources for reproductive health advocacy in these countries.

Adolescent↗