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At least 19 recordsLinked to original sources
PubMed2006

The perinatal autopsy: pertinent issues in multicultural Western Europe.

Western Europe is in a demographic transition with increasing multicultural societies. Health professionals have to understand the background, religious and cultural aspects of parents to counsel them regarding an autopsy in the event of a perinatal loss. Autopsy rates have declined over the past decades, the major limiting factor being the granting of permission for an autopsy, possibly because of adverse publicity or reluctance of doctors to obtain consent. Autopsy has proved its value in revealing unsuspected findings. The public can be convinced of this utility by means of good information notwithstanding their religious or cultural background.

Autopsy↗
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↗
PubMed2000

[Assurance and assessment of quality education in occupational medicine in selected countries of western Europe and in the United States. 1. Western Europe].

The author discusses the studies undertaken with the general aim to provide education in occupational medicine and assure and assess its quality in some countries of Western Europe advanced more than Poland in this area. It becomes quite evident that despite a widespread interest in quality of education, there is a lack of basic systemic solutions. A gap between basic theoretical and methodological guidelines and a large number of dispersed reports on concrete analytical and evaluation studies can be still observed. In addition to the presentation of an inside view of research activities carried out in some countries of Western Europe and the United States, based on selected professional publications, the author formulates general conclusions on how the assurance and quality assessment of education in occupational medicine function in those countries.

Education, Medical↗
PubMed1999

The involvement of the agriculture industry and government in animal disease emergencies and the funding of compensation in western Europe.

In Western Europe, the control and eradication of contagious animal diseases have always been subject to government legislation. In the event of an outbreak, the principal policy is 'stamping-out' (depopulation) of the infected herd. The owner of the herd is usually awarded financial compensation. The authors provide an overview of the involvement of the agriculture industry and government in animal disease emergencies and the funding of compensation in Western Europe. In particular, developments within the European Union are described, as illustrated by a case study in the Netherlands. The economic consequences of a widespread epidemic of classical swine fever (hog cholera) in the Netherlands in 1997 are described. Evaluation of the epidemic demonstrated that special emphasis needs to be placed on factors such as the high-risk period, animal movement, the attitude of farmers towards risk and the structure of compensation. Epidemic disease insurance schemes are considered to be a possible alternative in alleviating certain financial losses caused by disease outbreaks.

Agriculture↗
PubMed1993

Strategies for immunization against hepatitis B in western Europe.

In western Europe there has been a striking decline in the incidence of hepatitis B virus infection during the second half of the 1980s. Only a minor part of this decrease is the effect of vaccination, since rather limited vaccination programmes have been introduced in most west European countries. The policies for recommendation of hepatitis B vaccination have differed from north to south in Europe due to different risks of exposure to hepatitis B virus. In Scandinavia, vaccination has mainly been recommended for health-care workers with frequent blood contact, while in Germany and in France vaccination has been recommended for all health-care workers with patient contact. Further south, as in Italy, all health-care workers have been considered a risk group, and vaccination is recommended for all newly recruited workers and students.

Europe↗
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↗
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↗
PubMed2002

Health care systems in Western Europe: an analytical approach.

Health care in the countries of Western Europe can be defined as a complex process of continuous innovation, i.e. of constantly implementing new combinations of science, technology, organisation, economics, politics, philosophy, opinions and fashion. Any element of this definition can influence the course of the health care process, whether or not combined with one or more of the other elements. This definition implies that health care systems as well as health care policy of the countries of Western Europe differ considerably. If we define a health care system as the legal and organisational framework, directed at producing, distributing, managing, regulating, supervising, co-ordinating and controlling health care activities in order to realise defined social health care values, no country can narrowly be compared to any other country. Such a comparison produces a huge basket of facts from which one can draw one conclusion only: each country acts to its own liking. The same applies for the concept of health care policy, i.e. a chosen course to achieve pre-set strategic objectives. Here too, every country acts to its own liking, where nobody is right and nobody is wrong. Consequently, the universal health care system does not exist. Consequently also, the analyst who takes a closer look at the health care systems of the countries of Western Europe, trying to map the differences, will discover a rather messy picture. All this being said, how do we deal with two burning questions? The first is: how can it be that, relatively speaking, the people of Western Europe are so healthy? Secondly: how do we clean up the mess or, in other words, how do we reform health care?

Delivery of Health Care↗
PubMed1994

Primary care, financing and gatekeeping in western Europe.

Primary care in western Europe is delivered by general practitioners (GPs) but their role within the overall health system is poorly understood. The aim of this article is to present an overview of the characteristics of general practice in the context of health systems and to describe their variability and interrelationships. Data were obtained from two main sources: publications of official organizations and EC research projects. The characteristics of general practice are described and analysed with regard to three features: mode of payment, gatekeeper function and practice organization and workload. Despite their focus on general practice as the cornerstone of the health system, western European countries differ considerably in the major characteristics of primary care. There is variability in the ratio of GPs to population and in the extent to which patients relate to individual physicians. Although all countries have universal health insurance, the mode of payment of GPs differs. In some countries, the gatekeeper function of general practice is more highly developed and the use of specialist services varies accordingly. Practice characteristics such as workload, length of consultation, ordering of tests and reappointments also vary with differences in payment and gatekeeping arrangements. In particular, fee-for-service was associated with weaker physician-patient relationships, reduced attractiveness of general practice, more home visiting and longer consultations. Strong gatekeeping arrangements are not incompatible with high public satisfaction and are associated with lower visit rates. However, strong gatekeeping is not characteristic of fee-for-service arrangements. These findings suggest a need for more concerted research that could inform policy decisions concerning primary care in the USA as well as in Europe.

Adolescent↗
PubMed2004

Taxation and life expectancy in Western Europe.

With the exception of Denmark, life expectancy in Western Europe has shown a significant increase over the last decades. During that period of time overall taxation has increased in most of the countries, especially in Denmark. We, therefore, examined whether taxation could influence life expectancy in Western Europe. We used information on the sum of income tax and employees' social contribution in percentage of gross wage earnings from the OECD database and data on disability adjusted life expectancy at birth from the World Health Organization database. We arbitrarily only included countries with populations in excess of 4 millions and thereby excluded smaller countries where tax exemption is part of the national monetary policy. We found that disability adjusted life expectancy at birth was inversely correlated to the total tax burden in Western Europe. We speculate whether a threshold exists where high taxes exert a negative influence on life expectancy despite increased welfare spending. The study suggests that tax burden should be considered among the multiple factors influencing life expectancy.

Europe↗
PubMed1999

Mosquito-borne viruses in western Europe: a review.

Several mosquito-borne arboviruses belonging to the genera Alphavirus, Flavivirus, and Bunyavirus have been reported to occur in mosquitoes and to infect humans and other vertebrates in western Europe. These zoonotic viruses circulate in nature either in an Aedes-mammal, Anopheles-mammal, or Culex-bird transmission cycle. Infected humans normally do not contribute to the virus circulation. West Nile virus (Flavivirus) caused an outbreak of fever, malaise, pain in eyes and muscles, and headache and encephalitis in southern France during 1962-1965, and an outbreak of encephalitis with a high case-fatality rate in Romania during 1996. West Nile virus has been isolated from birds, horses, and mosquitoes in Portugal, France, the former Czechoslovakia, and Romania. These data, together with reports of antibodies to West Nile virus in birds, domestic mammals, and humans in several other countries, show virus activity in southern and central Europe. Sindbis virus (Alphavirus) caused outbreaks of fever, rash, and arthralgia in northern Europe during 1981-1982, 1988, and 1995. Two California group viruses (Bunyavirus), Tahyna virus and Inkoo virus, have been identified in western Europe. Tahyna virus causes fever and respiratory symptoms and sometimes also central nervous system involvement. It occurs in most countries of central and southern Europe, and is most common in central Europe. Inkoo virus has not been associated with disease in humans in western Europe although Russian studies indicated that it can cause encephalitis. Inkoo virus occurs in northern Europe, especially in the far north. Batai virus of the Bunyamwera-group (Bunyavirus) occurs in southern, central, and northern Europe, most frequently in central Europe. The antibody prevalence in humans generally is very low, indicating that the potential of this virus as a human pathogen is probably low in Europe. The Lednice virus (Bunyavirus) has been reported only from the former Czechoslovakia and Romania, and apparently is not transmitted to humans. In addition to the six mosquito-borne viruses documented in western Europe, there is serological evidence of infection with a Semliki Forest complex virus (Alphavirus) in central and southern Europe. Although mosquito-borne viruses presently are not considered to be the cause of major health problems in western Europe, the morbidity caused by Sindbis virus, and the morbidity and mortality caused by West Nile virus, merit further studies on the ecology, epidemiology, and medical importance of these viruses. The California group of viruses and a virus of the Semliki Forest complex may be the cause of unrecognized health problems in western Europe. Specific sampling of potential vectors for virus isolation, detailed characterization of virus strains, and the use of fully characterized strains for serological diagnosis will help to elucidate the present and future potential of mosquito-borne viruses as human pathogens in Europe.

Alphavirus↗
PubMed1990

The diffusion of organ transplantation in Western Europe.

The moment of introduction of clinical organ transplantations varied in Western Europe from country to country. In retrospect, one can distinguish pioneering countries (most notably the U.K. and France), and countries that were early or late adopters of the new technologies. An early start did not necessarily lead to extensive diffusion of organ transplantations, as shown by the example of the U.K. In general, Western Europe is lagging behind the U.S.A. In diffusion of organ transplantation technologies. With few exceptions, the introduction and diffusion of organ transplantations in Western Europe have been largely autonomous developments, not regulated by government or third party payers and only slowed down by lack of organs, facilities or funds. The lack of organs has been reduced by the activities of organ procurement and exchange organisations, and perhaps by legislation promoting organ donation. Nevertheless, the growth of the number of patients waiting for an organ is in almost all countries outpacing the increase in availability of organs.

Diffusion of Innovation↗
PubMed1986

Kawasaki disease: a pathology survey in western Europe.

There is an increasing awareness that Kawasaki disease does occur outside Japan, but reliable data regarding the incidence of the disease in western Europe are lacking. Such information may be important, not only providing insight into the incidence but also indicating whether or not the pathology is comparable to that reported from Japan. For these reasons a survey has been initiated among pediatric pathologists in western Europe with the use of a questionnaire. The results show that the experience with Kawasaki disease of pediatric pathologists in western Europe is extremely limited. Only 25 cases have been reported. One may infer from these data that the incidence of Kawasaki disease in western Europe is far below that in Japan. The pathology encountered appears to be the same as that reported from Japan and the United States. This finding in particular may be important for further epidemiological studies regarding etiology and pathogenesis of Kawasaki disease.

Child, Preschool↗
PubMed1995

Recent trends in incidence of cervical cancer in several regions of south-western Europe.

In recent decades, most Western countries have experienced a decline in the incidence of invasive cervical cancer. More recently, a reversal of this trend has been noted in young women, especially in anglo-saxon countries. These trends have been attributed to the beneficial results of cervical cancer screening on the one hand, to the widespread increase of high risk sexual behaviors on the other. Recent trends in Latin European countries have not previously been studied. Time trends of incidence data from 10 regions of South-Western Europe (Geneva, Vaud, Calvados, Doubs, Bas-Rhin, Isère, Ragusa, Varese, Zaragoza and Navarra) were analysed by means of log-linear models. The data were provided for various periods of time between 1970 and 1990. The mean incidence rate varies threefold between Navarra where rates are the lowest to Calvados where they are the highest. The overall decrease rate is of the order of -3% per year but rate changes differ by age group. The reduction seems to concern mostly middle aged women. A definite trend could not be determined among younger women due to low case numbers. Thus, the hypothesis of a rising incidence in young women cannot be confirmed at this time.

Adolescent↗
PubMed2006

Surnames in Western Europe: a comparison of the subcontinental populations through isonymy.

We studied the isonymic structure of Western Europe using the distributions of 26.2 million surnames in 8 countries, 125 regions and 2094 towns of the Subcontinent. We found that, for the whole of Western Europe, Nei's distance was correlated with geographic distance (r=0.610+/-0.009). It was observed that at long geographic distances the isonymyc distance stays below linearity and tends to become asymptotic, and this was attributed to long distance migration. A dendrogram of the125 regions was built and the clusters identified by the dendrogram are almost exactly coincident with the nations of the Subcontinent. Random inbreeding calculated from isonymy, F(ST), was highest in Spanish regions, and lowest in France. The geographical distribution of alpha in 2094 towns, high in the Center and East of the Subcontinent and lower in Spain, is compatible with the settlement of subsequent waves of migrants moving from the West and from the South toward the centre of the Continent. The present surname structure of Western Europe is strictly linked to local languages.

Consanguinity↗
PubMedDate not supplied

Reforms in nursing education across Western Europe: implementation processes and current status.

The aim of this review was to provide a comprehensive outlook on nursing education reforms enacted in Western Europe in the last three decades. Specifically, this analysis aimed to describe major trends in the implementation processes of nursing education reforms and the current academic status of nursing programs across Western Europe. A critical analysis of the scientific literature and policy documents was conducted. The results indicate that two major phases of reform were initiated in nursing education over the last three decades. The first phase was geared at creating a unified European platform of solid preregistration programs. The second phase was predominantly geared at integrating nursing programs into higher education institutions. In contrast to the first stage of reform, which yielded unity, the second phase resulted in a notable variation among existing structures, levels of education, duration of studies, and the titles (degrees) awarded. As a result, Western Europe today represents a myriad of arrangements for preregistration nursing programs. Nursing has viewed these reforms in the education system as vital in promoting the profession and crucial for responding to the reforming health care system. This research indicates that nursing goals have only been partially obtained.

Curriculum↗
PubMed2006

Factors affecting supply and demand of anesthesiologists in Western Europe.

PURPOSE OF REVIEW: Current demographic and macroeconomic trends indicate that, in Western Europe, the demand for anesthesia services will continue to increase. It is, however, questionable whether there will be sufficient supply. RECENT FINDINGS: In Western Europe, admission to medical schools is typically restricted. The European Working Time Directive has decreased the clinical exposure of residents. Also, increasing feminization of the physician workforce and the aging of current practitioners may change the available workforce. Current healthcare reforms that include demand-lowering elements may also negatively affect supply and demand for anesthesiologists. SUMMARY: Steps must be taken to augment the number of practitioners to ensure a sufficient number of anesthesiologists. Employers will have to offer flexible working practices and adequate compensation to attract new anesthesiologists. Alternatively, more responsibilities and tasks may be allocated to well-trained anesthesia assistants (e.g. nurses). National anesthesia associations must improve and coordinate resident training, which may alleviate the recruitment problem. A European training standard in anesthesia might adjust the regional disequilibrium of supply and demand, as might salary competition. In the long run, the undersupply of anesthesiologists may be offset by factors such as more procedures being performed non-invasively and further demand-lowering healthcare policies.

Anesthesiology↗