Suchergebnisse

This report up-dates information on the national situation of cervical cancer screening in the member states of the European Union. There is yet high diversity in the status of cervical screening, and rapid changes expected to occur in the situation in many countries. It is important to underline differences in the health care and other components in order to allow a proper interpretation of the summary results published elsewhere in this Special Issue. The brief national descriptions along with up-dated information on the recent references are available from all but one member states.

European Guidelines for Quality Assurance in Cervical Cancer Screening have been initiated in the Europe Against Cancer Programme. The first edition established the principles of organised population-based screening and stimulated numerous pilot projects. The second multidisciplinary edition was published in 2008 and comprises similar to 250 pages divided into seven chapters prepared by 48 authors and contributors. Considerable attention has been devoted to organised, population-based programme policies which minimise adverse effects and maximise benefits of screening. It is hoped that this expanded guidelines edition will have a greater impact on countries in which screening programmes are still lacking and in which opportunistic screening has been preferred in the past. Other methodological aspects such as future prospects of human papillomavirus testing and vaccination in cervical cancer control have also been examined in the second edition; recommendations for integration of the latter technologies into European guidelines are currently under development in a related project supported by the European Union Health Programme. An overview of the fundamental points and principles that should support any quality-assured screening programme and key performance indicators are presented here in a summary document of the second guidelines edition in order to make these principles and standards known to a wider scientific community.

Building on theories of valuation and evaluation, we develop an analytical framework that outlines six elements of the process of consolidation of an idea in the public sphere. We then use the framework to analyse the process of consolidation of the idea of climate change mitigation between 1997 and 2013, focusing on the interplay between ecological and economic evaluations. Our content analysis of 1274 articles in leading newspapers in five countries around the globe shows that (1) ecological arguments increase over time, (2) economic arguments decrease over time, (3) the visibility of environmental nongovernmental organizations as carriers of ecological ideas increases over time, (4) the visibility of business actors correspondingly decreases, (5) ecological ideas are increasingly adopted by political and business elites and (6) a compromise emerges between ecological and economic evaluations, in the form of the argument that climate change mitigation boosts, rather than hinders economic growth. ; Peer reviewed

Abstract
Collaboration between public administration organizations and various stakeholders is often prescribed as a potential solution to the current complex problems of governance, such as climate change. According to the Advocacy Coalition Framework, shared beliefs are one of the most important drivers of collaboration. However, studies investigating the role of beliefs in collaboration show mixed results. Some argue that similarity of general normative and empirical policy beliefs elicits collaboration, while others focus on beliefs concerning policy instruments. Proposing a new divisive beliefs hypothesis, we suggest that agreeing on those beliefs over which there is substantial disagreement in the policy subsystem is what matters for collaboration. Testing our hypotheses using policy network analysis and data on climate policy subsystems in 11 countries (Australia, Brazil, the Czech Republic, Germany, Finland, Ireland, Japan, Korea, Portugal, Sweden, and Taiwan), we find belief similarity to be a stronger predictor of collaboration when the focus is divisive beliefs rather than normative and empirical policy beliefs or beliefs concerning policy instruments. This knowledge can be useful for managing collaborative governance networks because it helps to identify potential competing coalitions and to broker compromises between them.

Background: In asylum seekers and refugees, the frequency of mental disorders, such as depression, anxiety and post-traumatic stress disorder, is higher than the general population, but there is a lack of data on risk factors for the development of mental disorders in this population. Aim: This study investigated the risk factors for mental disorder development in a large group of asylum seekers and refugees resettled in high- and middle-income settings. Methods: Participant-level data from two randomized prevention studies involving asylum seekers and refugees resettled in Western European countries and in Turkey were pooled. The two studies randomized participants with psychological distress, but without a diagnosis of mental disorder, to the Self-Help Plus psychological intervention or enhanced care as usual. At baseline, exposure to potentially traumatic events was measured using the Harvard Trauma Questionnaire-part I, while psychological distress and depressive symptoms were assessed with the General Health Questionnaire and the Patient Health Questionnaire. After 3 and 6 months of follow-up, the proportion of participants who developed a mental disorder was calculated using the Mini International Neuropsychiatric Interview. Results: A total of 1,101 participants were included in the analysis. At 3- and 6-month follow-up the observed frequency of mental disorders was 13.51% (115/851) and 24.30% (207/852), respectively, while the frequency estimates after missing data imputation were 13.95% and 23.78%, respectively. After controlling for confounders, logistic regression analysis showed that participants with a lower education level ( p = .034), a shorter duration of journey ( p = .057) and arriving from countries with war-related contexts ( p = .017), were more at risk of developing mental disorders. Psychological distress ( p = .004), depression ( p = .001) and exposure to potentially traumatic events ( p = .020) were predictors of mental disorder development. Conclusions: This study identified several risk factors for the development of mental disorders in asylum seekers and refugees, some of which may be the target of risk reduction policies. The identification of asylum seekers and refugees at increased risk of mental disorders should guide the implementation of focused preventative psychological interventions.

In order to update the previous version of the European Code against Cancer and formulate evidence-based recommendations, a systematic search of the literature was performed according to the methodology agreed by the Code Working Groups. Based on the review, the 4th edition of the European Code against Cancer recommends:. "Take part in organized cancer screening programmes for:. •Bowel cancer (men and women)•Breast cancer (women)•Cervical cancer (women)." Organized screening programs are preferable because they provide better conditions to ensure that the Guidelines for Quality Assurance in Screening are followed in order to achieve the greatest benefit with the least harm. Screening is recommended only for those cancers where a demonstrated life-saving effect substantially outweighs the potential harm of examining very large numbers of people who may otherwise never have, or suffer from, these cancers, and when an adequate quality of the screening is achieved. EU citizens are recommended to participate in cancer screening each time an invitation from the national or regional screening program is received and after having read the information materials provided and carefully considered the potential benefits and harms of screening. Screening programs in the European Union vary with respect to the age groups invited and to the interval between invitations, depending on each country's cancer burden, local resources, and the type of screening test used. For colorectal cancer, most programs in the EU invite men and women starting at the age of 50-60 years, and from then on every 2 years if the screening test is the guaiac-based fecal occult blood test or fecal immunochemical test, or every 10 years or more if the screening test is flexible sigmoidoscopy or total colonoscopy. Most programs continue sending invitations to screening up to the age of 70-75 years.For breast cancer, most programs in the EU invite women starting at the age of 50 years, and not before the age of 40 years, and from then on every 2 years until the age of 70-75 years.For cervical cancer, if cytology (Pap) testing is used for screening, most programs in the EU invite women starting at the age of 25-30 years and from then on every 3 or 5 years. If human papillomavirus testing is used for screening, most women are invited starting at the age of 35 years (usually not before age 30 years) and from then on every 5 years or more. Irrespective of the test used, women continue participating in screening until the age of 60 or 65 years, and continue beyond this age unless the most recent test results are normal.

The EU Water Framework Directive1 (WFD) is an ambitious legislation framework to achieve good ecological and chemical status for all surface waters and good quantitative and chemical status for groundwater by 2027. A total of 111,062 surface waterbodies are presently reported on under the Directive, 46% of which are actively monitored for ecological status. Of these waterbodies 80% are rivers, 16% are lakes, and 4% are coastal and transitional waters. In the last assessment, 4% (4,442) of waterbodies still had unknown ecological status, while in 23% monitoring did not include in situ water sampling to support ecological status assessment2. For individual (mainly biological) assessment criteria the proportion of waterbodies without observation data is much larger; the full scope of monitoring under the WFD is therefore still far from being realised. At the same time, 60% of surface waters did not achieve 'good' status in the second river basin management plan and waterbodies in Europe are considered to be at high risk of having poor water quality based on combined microbial, physical and physicochemical indicators3.

Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines.

Publisher's version (útgefin grein) ; Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. Affected women frequently have metabolic disturbances including insulin resistance and dysregulation of glucose homeostasis. PCOS is diagnosed with two different sets of diagnostic criteria, resulting in a phenotypic spectrum of PCOS cases. The genetic similarities between cases diagnosed based on the two criteria have been largely unknown. Previous studies in Chinese and European subjects have identified 16 loci associated with risk of PCOS. We report a fixed-effect, inverse-weighted-variance meta-analysis from 10,074 PCOS cases and 103,164 controls of European ancestry and characterisation of PCOS related traits. We identified 3 novel loci (near PLGRKT, ZBTB16 and MAPRE1), and provide replication of 11 previously reported loci. Only one locus differed significantly in its association by diagnostic criteria; otherwise the genetic architecture was similar between PCOS diagnosed by self-report and PCOS diagnosed by NIH or non-NIH Rotterdam criteria across common variants at 13 loci. Identified variants were associated with hyperandrogenism, gonadotropin regulation and testosterone levels in affected women. Linkage disequilibrium score regression analysis revealed genetic correlations with obesity, fasting insulin, type 2 diabetes, lipid levels and coronary artery disease, indicating shared genetic architecture between metabolic traits and PCOS. Mendelian randomization analyses suggested variants associated with body mass index, fasting insulin, menopause timing, depression and male-pattern balding play a causal role in PCOS. The data thus demonstrate 3 novel loci associated with PCOS and similar genetic architecture for all diagnostic criteria. The data also provide the first genetic evidence for a male phenotype for PCOS and a causal link to depression, a previously hypothesized comorbid disease. Thus, the genetics provide a comprehensive view of PCOS that encompasses multiple diagnostic criteria, gender, reproductive potential and mental health. ; This work has been supported by MRC grant MC_U106179472 (FD, KO, JRBP), Samuel Oschin Comprehensive Cancer Institute Developmental Funds, Center for Bioinformatics and Functional Genomics and Department of Biomedical Sciences Developmental Funds (MRJ), NCI P30CA177558 (CH), NCI UM1CA186107 (PK), European Regional Development Fund (Project No. 2014-2020.4.01.15-0012) and the European Union's Horizon 2020 research and innovation program under grant agreements No 692065 (TL, RM, AS) and 692145 (RM), NICHD R01HD065029 (RS), Estonian Ministry of Education and Research (grant IUT34-16 to TL), NICHD R01HD057450 (MU), NICHD P50HD044405 (AD), NICHD R01HD057223 (AD), R01HD085227 (MGH, AD), deCode Genetics (GT, UT, KS, US), Raine Medical Research Foundation Priming Grant (BHM), SCGOPHCG RAC 2015-16/034 (SGW, BGAS), 2016-17/018 (BGAS), NIHR BRC, Wellcome Trust, MRC (TDS), Eris M. Field Chair in Diabetes Research (MOG), NIDDK P30 DK063491 (MOG), NIDDK U01DK094431, U01DK048381 (DE), NICHD U10HD38992 (RL), Estonian Ministry of Education and Research (grant IUT34-16), Enterprise Estonia (grant EU48695); the EU-FP7 Marie Curie Industry-Academia Partnerships and Pathways (IAPP, grant SARM, EU324509 to AS), Wellcome (090532, 098381, 203141); European Commission (ENGAGE: HEALTH-F4-2007-201413 to MIM), MRC G0802782, MR/M012638/1 (SF), Li Ka Shing Foundation, WT-SSI/John Fell Funds, NIHR Biomedical Research Centre, Oxford, Widenlife and NICHD 5P50HD028138-27 (CML), NICHD R01HD065029, ADA 1-10-CT-57, Harvard Clinical and Translational Science Center, from the National Center for Research Resources 1UL1 RR025758 (CKW). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ; Peer Reviewed

This overview describes the principles of the 4th edition of the European Code against Cancer and provides an introduction to the 12 recommendations to reduce cancer risk. Among the 504.6 million inhabitants of the member states of the European Union (EU28), there are annually 2.64 million new cancer cases and 1.28 million deaths from cancer. It is estimated that this cancer burden could be reduced by up to one half if scientific knowledge on causes of cancer could be translated into successful prevention. The Code is a preventive tool aimed to reduce the cancer burden by informing people how to avoid or reduce carcinogenic exposures, adopt behaviours to reduce the cancer risk, or to participate in organised intervention programmes. The Code should also form a base to guide national health policies in cancer prevention. The 12 recommendations are: not smoking or using other tobacco products; avoiding second-hand smoke; being a healthy body weight; encouraging physical activity; having a healthy diet; limiting alcohol consumption, with not drinking alcohol being better for cancer prevention; avoiding too much exposure to ultraviolet radiation; avoiding cancer-causing agents at the workplace; reducing exposure to high levels of radon; encouraging breastfeeding; limiting the use of hormone replacement therapy; participating in organised vaccination programmes against hepatitis B for newborns and human papillomavirus for girls; and participating in organised screening programmes for bowel cancer, breast cancer, and cervical cancer.

FMSR (Austria) ; Fonds de la Recherche Scientifique (FNRS) ; FWO (Belgium) ; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) ; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) ; Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) ; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; MES (Bulgaria) ; CERN (China) ; Chinese Academy of Sciences (CAS) ; MoST (China) ; National Natural Science Foundation of China (NSFC) ; COLCIEN-CIAS (Colombia) ; MSES (Croatia) ; Research Promotion Foundation (RPF) ; Academy of Sciences (Estonia) ; National Institute of Chemical Physics and Biophysics (NICPB) ; Academy of Finland ; ME (Finland) ; Helsinki Institute of Physics (HIP) ; Commissariat à l'énergie atomique et aux énergies alternatives (CEA) ; Institut national de physique nucléaire et de physique des particules (IN2P3/CNRS) ; Bundesministerium für Bildung und Forschung (BMBF) ; Deutsche Forschungsgemeinschaft (DFG) ; HGF (Germany) ; General Secretariat for Research and Technology (GSRT) ; Hungarian Scientific Research Fund (OTKA) ; NKTH (Hungary) ; Department of Atomic Energy (DAE) - India ; Department of Science and Technology (DST) - India ; Institute for Research in Fundamental Sciences (IPM) ; Science Foundation Ireland (SFI) ; Istituto Nazionale di Fisica Nucleare (INFN) ; National Research Foundation of Korea (NRF) ; LAS (Lithuania) ; Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV) ; Consejo Nacional de Ciencia y Tecnología (CONACYT) ; SEP (Mexico) ; UASLP-FAI (Mexico) ; Pakistan Atomic Energy Commission (PAEC) ; SCSR (Poland) ; Fundação para a Ciência e a Tecnologia (FCT) ; Joint Institute for Nuclear Research (JINR) ; MST (Russia) ; MAE (Russia) ; MSTDS (Serbia) ; MICINN (Spain) ; Centro Nacional de Física de Partículas, Astropartículas y Nuclear (CPAN) ; Swiss Funding Agencies (Switzerland) ; NSC (Taipei) ; Scientific and Technological Research Council of Turkey (TUBITAK) ; Türkiye Atom Enerjisi Kurumu (TAEK) ; Science and Technology Facilities Council (STFC) ; DOE (USA) ; National Science Foundation (NSF) - USA ; European Union ; Leventis Foundation ; A. P. Sloan Foundation ; Alexander von Humboldt Foundation ; During autumn 2008, the Silicon Strip Tracker was operated with the full CMS experiment in a comprehensive test, in the presence of the 3.8 T magnetic field produced by the CMS superconducting solenoid. Cosmic ray muons were detected in the muon chambers and used to trigger the readout of all CMS sub-detectors. About 15 million events with a muon in the tracker were collected. The efficiency of hit and track reconstruction were measured to be higher than 99% and consistent with expectations from Monte Carlo simulation. This article details the commissioning and performance of the Silicon Strip Tracker with cosmic ray muons.