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In January 2011, the Australian Council for Educational Research was contracted by the Department of Education, Employment and Workplace Relations (DEEWR) to collate information gleaned from a range of sources and prepare a report that made clear the benefits associated with stronger relationships between schools and businesses. ACER was also asked to assess the existing evidence base in an Australian context and identify ways in which this could be strengthened. Given the complex demands faced by schools in the twenty-first century, and the limited nature of the resources available to meet these demands, schools and governments are increasingly looking to external partners to support their needs. There has been a shift at the policy level globally towards more inclusive, collaborative and holistic ways of working. As in the area of health, in education there is 'a growing recognition of the need to help schools cope with the complex challenges they face'. 'Schools can't do it alone'; they are increasingly looking to communities to help build capacity and improve educational outcomes (Berg, Melaville & Blank, 2006). In the United Kingdom, the National Council for Educational Excellence has recommended that employers support the delivery of a new National Framework for business education partnerships 'so that, by 2010, every school and college should have effective relationships with business'. In late 2010, the Victorian Department of Education and Early Childhood Development launched the Business Working with Education Foundation, which is intended to foster business and school partnerships. The establishment of the Business-School Connections Roundtable by the Commonwealth Government is further evidence of high level commitment to facilitating greater business involvement in education. This report examines the evidence that supports the case for increased school–business connections; the range of benefits for young people, teachers, school communities and business from these connections; and the strengths of, and areas for improvement in, current and emerging research in this area in an Australian context. The report is based on a brief overview of the international and national literature since 2007, interviews with members of the National Framework and Guiding Principles Working Group established by the Business-School Connections Roundtable, and a selection of case studies. The case studies include interviews with business representatives and information gathered by email from overseas school and business partners. Case Studies are from Brisbane State High School (QLD); Gymea Technology High School (NSW); Windsor Gardens Vocational College (SA); Hunter Water Corporation; The Hawaiian Alive Program (WA); Landcare Australia; Time to Read; IBM's KidSmart Early Learning Program; Linking Work With Learning; Gregg's Breakfast

This report from the Working Group on Levees and Flood Defences of the European Club of ICOLD (EUCOLD) is published in preparation for the 2018 ICOLD Congress in Vienna; this European Levee Report also includes a contribution from the USA, from the Levees Comittee of the United States Society on Dams (USSD). The objective of the report is to provide an overview of flood protection works and its issues in different countries. The situation of levees in the eleven countries who participated to the report is presented in a specific chapter, including facts and figures about levees and flood defences, flood risk issues, major flood events, regulation, governance, technical guidance, management practices and finally knowledge gaps. A final chapter presents an analysis and a tentative synthesis of the collected information. The main outcomes of this report are the high importance of flood defences in these countries in terms of infrastructure portfolio and of flood risk management, and the lack of an central levee inventory in the majority of these countries. Levees seem to be a relevant issue in many countries or at least for many regions across European Countries. Countries like England, France, Germany, Italy, The Netherlands, Poland, Spain, and others each have several thousand kilometres of levees and many more still have a significant amount of levees. The majority of levees and flood protection structures are found along rivers but, especially in Western Europe, a significant fraction of levees and structures have been built along the coasts and estuaries. Levees often have a long and complicated construction history, many of them have been heightened step by step after major flood events. For the whole of Europe, both annual flood damage and Flood Risk Management (FRM) investments run into the billions of Euros (per year), while the protected value is over two trillion Euro. Levee management governance and legislation strongly differ by country. There is no central levee database and, from many countries, only estimated data and incomplete information were available. ; Ce rapport du Groupe de travail sur les Digues et ouvrages de protection contre les inondations du Club européen de la CIGB (EUCOLD) est publié en préparation du Congrès de la CIGB 2018 à Vienne; ce rapport sur les digues, initialement européen, comprend également une contribution des États-Unis, du Comité sur les digues de l'United States Society on Dams (USSD). L'objectif du rapport est de fournir un aperçu des ouvrages de protection contre les inondations et des problématiques associées dans différents pays. La situation des digues (ou levées) dans les onze pays ayant participé au rapport est présentée dans un chapitre spécifique : faits et chiffres sur les levées et les inondations, risque d'inondation, inondations majeures, réglementation, gouvernance, conseils techniques, pratiques de gestion et enfin lacunes en termes de connaissances. Un dernier chapitre présente une analyse et une tentative de synthèse des informations collectées. Ce rapport démontre la grande importance des ouvrages de protection contre les inondations dans ces pays en termes de patrimoine d'infrastructures et de gestion des risques d'inondation, et l'absence d'un inventaire central des digues dans la majorité de ces pays. Les digues semblent être une question d'importance dans de nombreux pays ou au moins pour de nombreuses régions à travers les pays européens. Des pays comme l'Angleterre, la France, l'Allemagne, l'Italie, les Pays-Bas, la Pologne, l'Espagne et d'autres ont chacun plusieurs milliers de kilomètres de digues et beaucoup d'autres en ont également un linéaire important. La majorité des digues et structures de protection contre les inondations se trouvent le long des rivières, mais, en particulier en Europe de l'Ouest, une partie importante en a été construite le long des côtes et des estuaires. Les levées ont souvent une histoire de construction longue et compliquée, beaucoup d'entre elles ont été rehaussées pas à pas après les inondations majeures. Pour l'ensemble de l'Europe, les dommages annuels causés par les inondations et les investissements dans la gestion des risques liés aux inondations se chiffrent en milliards d'euros (par an), tandis que la valeur protégée dépasse les deux billions d'euros. La législation en matière de gestion et de gouvernance des digues diffère fortement d'un pays à l'autre. Il n'y a pas de base de données centrale sur les digues et, dans de nombreux pays, seules des données estimées et des informations incomplètes étaient disponibles.

Sport is a social phenomenon that can be defined from multiple perspectives. Legislation in Colombia defined sport as a specific human behavior characterized by a playful and competitive zeal attitude expressed through body and mental exercise, within established rules and disciplines aimed at generating moral, civic and social values. For the International Working Group of the United Nations on Sport for Development and Peace, sport is "all forms of physical activity that contributes to achieve good physical condition, mental health and social inte­raction, such as games, recreation, and competition or organized sports and indigenous games." Sport has attri­butes that make it as a vehicle to promote development and peace. However, sport alone can`t guarantee peace or solve social problems associated with conflicts. It is also recognized that sports activities, presents risks and limitations as the exploitation of children and youth with athletic skills, aggressive and violent behavior between teams and fans that encourage unethical behavior (aggression, doping, fraud and corruption). To know the advantages and risks involved in sports activities and the meaning who have had in other countries as a develop­ment strategy, in terms of research is considered an emerging field with little means assessment to demonstrate the effectiveness of sport in building peace. It is expected to know the actions that have been advanced in Colombia through state of the art, gathering reliable evidence base supporting its use and build a platform for programs that use sport as a tool in peace building. ; El deporte es un fenómeno social que puede ser definido desde múltiples perspectivas. La legislación deportiva en Colombia lo define como una específica conducta humana caracterizada por una actitud lúdica y de afán competitivo expresada mediante el ejercicio corporal y mental, dentro de disciplinas y normas preestablecidas orientadas a generar valores morales, cívicos y sociales. Para el Grupo de Trabajo Interinstitucional de las Nacio­nes Unidas sobre el Deporte para el Desarrollo y la Paz, el deporte es "toda forma de actividad física que contribu­ya al logro de una buena condición física, salud mental e interacción social, como los juegos, la recreación, los deportes organizados y de competencia y los juegos y deportes autóctonos". El deporte posee atributos que lo convierten en un vehículo para promover el desarrollo y la paz. Sin embargo, el deporte por sí solo no puede garantizar la paz ni resolver los problemas sociales asociados al conflicto en Colombia. Se reconoce también que la actividad deportiva presenta riesgos y limitaciones como la explotación de niños y jóvenes con capacidades deportivas, la rivalidad agresiva y violenta entre equipos y fanáticos que fomentan conductas poco éticas (agre­sión, doping, fraude y corrupción). Conociendo las ventajas y riesgos que implican las actividades deportivas y el uso que algunos países le han dado al deporte como estrategia de desarrollo, en términos de investigación es considerado un campo emergente con escasos medios de evaluación que demuestren la efectividad del deporte en la construcción de la paz. Se espera conocer las acciones que se han adelantado en Colombia a través del estado del arte, reunir una base de evidencias fiables que respalden su uso y consolidar una plataforma de programas que utilizan el deporte como herramienta en la construcción de la paz.

A mandatory national Irish bovine viral diarrhoea (BVD) eradication programme, coordinated by Animal Health Ireland, commenced in 2013. Key decisions and programme review are undertaken by a cross-industry Implementation Group (BVDIG) supported by a Technical Working Group. Ear notch tissue is collected from all new-born calves using modified official identity tags, supplemented by additional blood sampling, including for confirmatory testing of calves with initial positive results and testing of their dams. Testing is delivered by private laboratories in conjunction with the National Reference Laboratory, with all results reported to a central database. This database manages key elements of the programme, issuing results to herdowners by short message service messaging supplemented by letters; assigning and exchanging animal-level statuses with government databases of the Department of Agriculture, Food and the Marine to enable legislated restrictions on animal movements; assigning negative herd status based on test results; generating regular reports for programme management and evaluation and providing herd-specific dashboards for a range of users. Legislation supporting the programme has been in place throughout but has not thus far mandated the slaughter of persistently infected (PI) calves. A key challenge in the early years, highlighted by modeling, was the retention of PI animals by some herd owners. This has largely been resolved by measures including graduated financial supports to encourage their early removal, herd-level movement restrictions, ongoing programme communications and the input of private veterinary practitioners (PVPs). A framework for funded investigations by PVPs in positive herds was developed to identify plausible sources of infection, to resolve the status of all animals in the herd and to agree up to three measures to prevent re-introduction of the virus. The prevalence of PI calves in 2013 was 0.66%, within 11.3% of herds, reducing in each subsequent year, to 0.03 and 0.55%, ...

The article focuses on the internationalisation of education and competences approach in the digital world as viewed by experts from different countries: the Netherlands, Poland, Turkey, Russia, and Ukraine. The article aims to provide opinions, views, and reflections on important topics addressed by the IRNet project and DLCC2017 Conference participants. ; A digital single market strategy for Europe. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions. Brussels, 6 May 2015. Accessed 9 March 2018. Retrieved from http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52015DC0192&from=EN. An Agenda for new skills and jobs: A European contribution towards full employment. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions. Strasburg, 23 November 2010. Accessed 9 March 2018. Retrieved from http://eur-lex.europa.eu/resource.html?uri=cellar:776df18f-542f-48b8-9627-88aac6d3ede0.0003.03/DOC_1&format=PDF. A new skills agenda for Europe. Working together to strengthen human capital, employability and competitiveness. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions. Brussels, 10 June 2016. Accessed 09 March 2018. Retrieved from https://ec.europa.eu/transparency/regdoc/rep/1/2016/EN/1-2016-381-EN-F1-1.PDF. A strategy for smart, sustainable and inclusive growth. Communication from the Commission Europe 2020. Brussels, 3 March 2010. Accessed 9 March 2018. Retrieved from http://ec.europa.eu/eu2020/pdf/COMPLET%20EN%20BARROSO%20%20%20007%20-%20Europe%202020%20-%20EN%20version.pdf. Chatti, M. A., Schroeder, U., Jarke, M. (2012). LaaN: Convergence of Knowledge Management and Technology-Enhanced Learning. In: IEEE Transactions on Learning Technologies, 5(2), 177–189. Retrieved March 03, 2019, from https://ieeexplore.ieee.org/abstract/document/6095503 Digital agenda for Europe: Key publications. Accessed 09 March 2018. Retrieved from https://ec.europa.eu/digital-single-market/en/digital-agenda-europe-key-publications. European Commission / Eurostat / Europe 2020 Indicators / Europe 2020 strategy. Accessed 9 March 2018. Retrieved from http://ec.europa.eu/eurostat/web/europe-2020-indicators. Ghavifekr, S. & Rosdy, W. A. W. (2015). Teaching and learning with technology: Effectiveness of ICT integration in schools. International Journal of Research in Education and Science, 1(2), 175–191. Jensen, K. B. (2015). What's social about social media? Social Media + Society, 1(1). Accessed 09 Match 2018. Retrieved from http://sms.sagepub.com/content/1/1/2056305115578874.full. Kampylis, P. Punie, Y., & Devine, J. (2015). Promoting effective digital-age learning. A European framework for digitally-competent educational organisations. Accessed 9 March 2018. Retrieved from https://ec.europa.eu/jrc/en/publication/eur-scientific-and-technical-research-reports/promoting-effective-digital-age-learning-european-framework-digitally-competent-educational. Kommers, P., Smyrnova-Trybulska, E., Morze, N., Issa, Tomayess, & Issa Theodora. (2015). Conceptual aspects: Analyses of the legal, ethical, human, technical, social factors of the development of ICT, e-learning and intercultural development in different countries setting out the previous new theoretical model and preliminary findings Int. J. Continuing Engineering Education and Life-long Learning, Vol. 25, No. 4, pp. 365-393 Navitas Ventures report. Digital transformation in higher education. Accessed 28 January 2018. Retrieved from https://www.navitasventures.com/insights/digital-transformation-higher-education/. Opening up education: Innovative teaching and learning for all through new technologies and open educational resources. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions. Brussels, 25 September 2013. Accessed 9 March 2018. Retrieved from http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52013DC0654&from=EN. Order of the Ministry of Education and Science of Russia, 23 August 2017, No. 816. Accessed 28 January 2018. Retrieved from https://minjust.consultant.ru/documents/36757?items=1&page=1. Professional standard of the teacher in Russian Federation. Accessed 28 January 2018. Retrieved from http://fgosvo.ru/docs/101/69/2/1. Strategic framework for European cooperation in education and training ("ET 2020"). Accessed 9 March 2018. Retrieved from http://ec.europa.eu/education/policy/strategic-framework_en. The Digital Skills and Jobs Coalition. Accessed 9 March 2018. Retrieved from https://ec.europa.eu/digital-single-market/en/digital-skills-jobs-coalition. The Law on Education in Russian Federation. Accessed 28 January 2018. Retrieved from http://zakon-ob-obrazovanii.ru/. Vuorikari, R., Punie, Y., Carretero, S., & Brande L. Van den. DigComp 2.0: The digital competence framework for citizens. Update phase 1: The conceptual reference mode. Accessed 9 March 2018. Retrieved from http://publications.jrc.ec.europa.eu/repository/bitstream/JRC101254/jrc101254_digcomp%202.0%20the%20digital%20competence%20framework%20for%20citizens.%20update%20phase%201.pdf. Working Group on Education. (2017). Digital skills for life and work. UNESCO. September 2017. Accessed 28 January 2018. Retrieved from https://unesdoc.unesco.org/ark:/48223/pf0000259013.

Globally, chronic kidney disease (CKD) is an emerging public health challenge but accurate data on its true prevalence are scarce, particularly in poorly resourced regions such as sub-Saharan Africa (SSA). Limited funding for population-based studies, poor laboratory infrastructure and the absence of a validated estimating equation for kidney function in Africans are contributing factors. Consequently, most available studies used to estimate population prevalence are hospital-based, with small samples of participants who are at high risk for kidney disease. While serum creatinine is most commonly used to estimate glomerular filtration, there is considerable potential bias in the measurement of creatinine that might lead to inaccurate estimates of kidney disease at individual and population level. To address this, the Laboratory Working Group of the National Kidney Disease Education Program published recommendations in 2006 to standardize the laboratory measurement of creatinine. The primary objective of this review was to appraise implementation of these recommendations in studies conducted in SSA after 2006. Secondary objectives were to assess bias relating to choice of estimating equations for assessing glomerular function in Africans and to evaluate use of recommended diagnostic criteria for CKD. This study was registered with Prospero (CRD42017068151), and using PubMed, African Journals Online and Web of Science, 5845 abstracts were reviewed and 252 full-text articles included for narrative analysis. Overall, two-thirds of studies did not report laboratory methods for creatinine measurement and just over 80% did not report whether their creatinine measurement was isotope dilution mass spectroscopy (IDMS) traceable. For those reporting a method, Jaffe was the most common (93%). The four-variable Modification of Diet in Renal Disease (4-v MDRD) equation was most frequently used (42%), followed by the CKD Epidemiology Collaboration (CKD-EPI) equation for creatinine (26%). For the 4-v MDRD equation and CKD-EPI equations, respectively, one-third to one half of studies clarified use of the coefficient for African-American (AA) ethnicity. When reporting CKD prevalence, <15% of studies fulfilled Kidney Disease: Improving Global Outcomes criteria and even fewer used a population-based sample. Six studies compared performance of estimating equations to measured glomerular filtration rate (GFR) demonstrating that coefficients for AA ethnicity used in the 4-v MDRD and the CKD-EPI equations overestimated GFR in Africans. To improve on reporting in future studies, we propose an 'easy to use' checklist that will standardize reporting of kidney function and improve the quality of studies in the region. This research contributes some understanding of the factors requiring attention to ensure accurate assessment of the burden of kidney disease in SSA. Many of these factors are difficult to address and extend beyond individual researchers to health systems and governmental policy, but understanding the burden of kidney disease is a critical first step to informing an integrated public health response that would provide appropriate screening, prevention and management of kidney disease in countries from SSA. This is particularly relevant as CKD is a common pathway in both infectious and non-communicable diseases, and multimorbidity is now commonplace, and even more so when those living with severe kidney disease have limited or no access to renal replacement therapy.

Over the last few decades, human beings are facing the worst challenges of violence, terrorism and wars apart from health related challenges. Health and peace are the fundamental rights of every human being and are interlinked. Relationship between health and peace is dynamic and bilateral. Peace is an important determinant of health while attainment of peace depends upon health of all people.1-3Both health and peace have a very broad meaning. World Health Organization (WHO) defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".3 Similarly, "peace" is currently taken as not just the absence or reduction of war but include negation of violence, presence of harmony, justice, equity; and the capacity to handle conflict in a nonviolent manner.4 Global peace is under threat by various conflicts, violence, terrorism and wars. During second half of 20th century, power game among superpowers resulted in open warfare, cold wars and proxy wars, leading to violent conflicts across the world. Worldwide, conflicts arising from any geopolitical, ethnic, religious and economic matters are handled either by a nonviolent peaceful way or through violence and wars. The use of violence for conflict resolution and peace building is not justified as violence itself is considered as opposite to peace and peace should only be achieved by peaceful means. 5,6 Violence, civil wars and terrorism are major threats to global health. Along with economic and infrastructural damage, wars contribute to increased mortality and morbidly with detrimental effects on physical and psychological health of the population.7 According to Global Burden of Disease Study, wars will be the 8th leading cause of disability and death by 2020.8 Iraq war led to the loss of 1,16,903 Iraqi civilians and more than 4,800 coalition military personnel from 2003-11.9 In Afghanistan, conflict and terrorism is the leading cause of disability-adjusted life years (DALYs) lost.10 Pakistan is also affected by violent conflict with an increasing trend over the last couple of decades.11 This resulted in 63,554 deaths in Pakistan from 2000-2018.12 The economic burden on Pakistan due to incidents of terrorism from 2001-20018 was US$126.79 billion.13 Achieving the goal of desirable standard of health for all people needs sustainable, long-term peacebuilding measures by reducing all forms of violence and wars. United Nations General Assembly in its resolution no 34/58 stated: "Peace and security, in their turn, are important for the preservation and improvement of the health of all people, and that cooperation among nations on vital health issues can contribute importantly to peace".14 This gigantic task needs a multidisciplinary approach and cannot be achieved without involvement of the health professionals - as highlighted by WHO- resolution number 34.38 in 34th World Health Assembly.15 Various organizations like "International Committee of the Red Cross", "International Physicians for the Prevention of Nuclear War", "International Campaign to Ban Landmines" and others have worked on the involvement of health force in peace building process.16 In 1984, Pan American Health Organization (PAHO), introduced the concept of "Health as a Bridge for Peace (HBP)"17 which was later on adopted by WHO in 1998 during 51st World Health Assembly.18 HBP aimed to support the health workers in providing healthcare services in conflict affected zones and simultaneously avail all the opportunities to promote peace through various health related activities.19 Health related initiatives are not only helpful in reducing morbidity and mortality during wars but can also be useful in prevention, resolution and transformation of conflicts before, during and after violent conflicts and wars."Peace through health (PtH)" is another important peace work initiative from McMaster University, addressing the role of health workers in promoting peace through various health interventions in context of war and conflict.16,20,21 "PtH working group has identified various mechanisms that can explain the peace-work performed by health-workers.21,22 Health professionals are already equipped with knowledge, certain skills, values and qualities that can be utilized in handling violent conflicts and promotion of peace in many situations.5,16Like any other program, there are some limitations of PBH & PtH programs as well. There is no evidence-based, systematic evaluation of the impact of peace through health initiatives.16, 23 Some quarters advocate that health professionals are only concerned with health care delivery in war-affected areas and should not be involved in conflicts and peacebuilding process. Neutrality and impartiality of healthcare workers in certain situations can also be compromised. Questions are also being raised regarding formal education and appropriate skills of health care workers in conflict management and peace-building process.16, 24-26 However, the usefulness of peace through health theory has not been refuted through solid evidence. 20As already discussed, South Asian region, including Pakistan and Afghanistan are confronting violent conflicts, wars and terrorism during the recent past. There is a dire need of seeking every opportunity to achieve and promote peace in Pakistan, Afghanistan and the region. The involvement of health professionals in this highly needed and noble cause is a proven and viable strategy. A strategic plan may be developed for integration of health-care delivery system with the prevention and transformation of violent conflicts and wars. Special peace-based training courses should be arranged for health care providers in war affected areas and high intensity conflict zones. Incorporation of peace and conflict studies in undergraduate medical curriculum and postgraduate public-health curriculum at university level will be a way forward in achieving peace through health in Pakistan and the region.

ENIGMA-CNV working group. ; Low-frequency 1q21.1 distal deletion and duplication copy number variant (CNV) carriers are predisposed to multiple neurodevelopmental disorders, including schizophrenia, autism and intellectual disability. Human carriers display a high prevalence of micro- and macrocephaly in deletion and duplication carriers, respectively. The underlying brain structural diversity remains largely unknown. We systematically called CNVs in 38 cohorts from the large-scale ENIGMA-CNV collaboration and the UK Biobank and identified 28 1q21.1 distal deletion and 22 duplication carriers and 37,088 non-carriers (48% male) derived from 15 distinct magnetic resonance imaging scanner sites. With standardized methods, we compared subcortical and cortical brain measures (all) and cognitive performance (UK Biobank only) between carrier groups also testing for mediation of brain structure on cognition. We identified positive dosage effects of copy number on intracranial volume (ICV) and total cortical surface area, with the largest effects in frontal and cingulate cortices, and negative dosage effects on caudate and hippocampal volumes. The carriers displayed distinct cognitive deficit profiles in cognitive tasks from the UK Biobank with intermediate decreases in duplication carriers and somewhat larger in deletion carriers—the latter potentially mediated by ICV or cortical surface area. These results shed light on pathobiological mechanisms of neurodevelopmental disorders, by demonstrating gene dose effect on specific brain structures and effect on cognitive function. ; 1000BRAINS: The 1000BRAINS study was funded by the Institute of Neuroscience and Medicine, Research Center Juelich, Germany. We thank the Heinz Nixdorf Foundation (Germany) for the generous support of the Heinz Nixdorf Recall Study on which 1000BRAINS is based. We also thank the scientists and the study staff of the Heinz Nixdorf Recall Study and 1000BRAINS. Funding was also granted by the Initiative and Networking Fund of the Helmholtz Association (Caspers) and the European Union's Horizon 2020 Research and Innovation Programme under Grant Agreement 945539 (Human Brain Project SGA3; Amunts, Caspers, Cichon). Brainscale: The Brainscale study was supported by the Netherlands Organization for Scientific Research MagW 480-04-004 (Dorret I. Boomsma), 51.02.060 (Hilleke E. Hulshoff Pol), 668.772 (Dorret I. Boomsma and Hilleke E. Hulshoff Pol); NWO/SPI 56-464-14192 (Dorret I. Boomsma), the European Research Council (ERC-230374) (Dorret I. Boomsma), High Potential Grant Utrecht University (Hilleke E.Hulshoff Pol) and NWO Brain and Cognition 433-09-220 (Hilleke E.Hulshoff Pol). Betula: The Betula study was funded by the Knut and Alice Wallenberg (KAW) foundation (Nyberg). The Freesurfer segmentations on the Betula sample were performed on resources provided by the Swedish National Infrastructure for Computing (SNIC) at HPC2N (in Umeå, Sweden), partially funded by the Swedish Research Council through grant agreement no. 2018-05973. Brain Imaging Genetics (BIG): This work makes use of the BIG database, first established in Nijmegen, The Netherlands, in 2007. This resource is now part of Cognomics (www.cognomics.nl), a joint initiative by researchers from the Donders Centre for Cognitive Neuroimaging, the Human Genetics and Cognitive Neuroscience departments of the Radboud University Medical Centre and the Max Planck Institute for Psycholinguistics in Nijmegen. The Cognomics Initiative has received support from the participating departments and centres and from external grants, that is, the Biobanking and Biomolecular Resources Research Infrastructure (Netherlands) (BBMRI-NL), the Hersenstichting Nederland and the Netherlands Organization for Scientific Research (NWO). The research leading to these results also receives funding from the NWO Gravitation grant 'Language in Interaction', the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement nos. 602450 (IMAGEMEND), 278948 (TACTICS) and 602805 (Aggressotype), as well as from the European Community's Horizon 2020 programme under grant agreement no. 643051 (MiND) and from ERC-2010-AdG 268800-NEUROSCHEMA. In addition, the work was supported by a grant for the ENIGMA Consortium (grant number U54 EB020403) from the BD2K Initiative of a cross-NIH partnership. deCODE genetics: deCODE genetics acknowledges support from the Innovative Medicines Initiative Joint Undertaking under grant agreement nos. 115008 (NEWMEDS) and 115300 (EUAIMS), of which resources are composed of EFPIA in-kind contribution and financial contribution from the European Union's Seventh Framework Programme (EU-FP7/2007-2013), EU-FP7-funded grant agreement no. 602450 (IMAGEMEND) and EU-funded FP7-People-2011-IAPP grant agreement no. 286213 (PsychDPC). Dublin: This work was supported by Science Foundation Ireland (SFI grant 12/IP/1359 to Gary Donohoe and grant SFI08/IN.1/B1916-Corvin to Aidan C. Corvin). ECHO-DEFINE: The ECHO study acknowledges funding from a Medical Research Council (MRC) Centre Grant to Michael J. Owen (G0801418), the Wellcome Trust (Institutional Strategic Support Fund (ISSF) to van den Bree and Clinical Research Training Fellowship to Joanne L. Doherty), the Waterloo Foundation (WF 918-1234 to van den Bree), the Baily Thomas Charitable Fund (2315/1 to van den Bree), National Institute of Mental Health (NIMH 5UO1MH101724 to van den Bree and Michael J. Owen), the IMAGINE-2 study (funded by the MRC (MR/T033045/1) to van den Bree, Jeremy Hall and Michael J. Owen), the IMAGINE-ID study (funded by MRC (MR/N022572/1) to Jeremy Hall, van den Bree and Owen). The DEFINE study was supported by a Wellcome Trust Strategic Award (100202/Z/12/Z) to Michael J. Owen. ENIGMA: ENIGMA is supported in part by NIH grants U54 EB20403, R01MH116147 and R56AG058854. NIA T32AG058507; NIH/NIMH 5T32MH073526. EPIGEN-Dublin: The EPIGEN-Dublin cohort was supported by a Science Foundation Ireland Research Frontiers Programme award (08/RFP/GEN1538). EPIGEN-UK (Sisodiya): The work was partly undertaken at UCLH/UCL, which received a proportion of funding from the UK Department of Health's NIHR Biomedical Research Centres funding scheme. We are grateful to the Wolfson Trust and the Epilepsy Society for supporting the Epilepsy Society MRI scanner. GAP: This work was supported by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, Psychology and Neuroscience, King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. GOBS: The GOBS study data collection was supported in part by the National Institutes of Health (NIH) grants: R01 MH078143, R01 MH078111 and R01 MH083824, with work conducted in part in facilities constructed under the support of NIH grant C06 RR020547. GSP: Data were in part provided by the Brain Genomics Superstruct Project (GSP) of Harvard University and Massachusetts General Hospital (MGH) (Principal Investigators: Randy Buckner, Jordan Smoller and Joshua Roffman), with support from the Center for Brain Science Neuroinformatics Research Group, Athinoula A. Martinos Center for Biomedical Imaging, Center for Genomic Medicine and Stanley Center for Psychiatric Research. Twenty individual investigators at Harvard and MGH generously contributed data to the overall project. We would like to thank Randy Buckner for insightful comments and feedback on this work. HUBIN: The HUBIN study was financed by the Swedish Research Council (K2010-62X-15078-07-2, K2012-61X-15078-09-3, 521-2014-3487 K2015-62X-15077-12-3, 2017-00949), the regional agreement on medical training and clinical research between Stockholm County Council and the Karolinska Institutet. HUNT: The HUNT study is a collaboration between HUNT Research Centre (Faculty of Medicine and Movement Sciences, NTNU—Norwegian University of Science and Technology), Nord-Trøndelag County Council, Central Norway Health Authority and the Norwegian Institute of Public Health. HUNT-MRI was funded by the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, and the Norwegian National Advisory Unit for functional MRI. IMAGEN: This work received support from the following sources: the European Union-funded FP6 Integrated Project IMAGEN (reinforcement-related behaviour in normal brain function and psychopathology) (LSHM-CT- 2007-037286), the Horizon 2020 funded ERC Advanced Grant 'STRATIFY' (Brain network based stratification of reinforcement-related disorders) (695313), ERANID (Understanding the Interplay between Cultural, Biological and Subjective Factors in Drug Use Pathways) (PR-ST-0416-10004), BRIDGET (JPND: BRain Imaging, cognition Dementia and next generation GEnomics) (MR/N027558/1), Human Brain Project (HBP SGA 2, 785907),the FP7 projects IMAGEMEND(602450; IMAging GEnetics for MENtal Disorders) and MATRICS (603016), the Innovative Medicine Initiative Project EUAIMS (115300-2), the Medical Research Council Grant 'c-VEDA' (Consortium on Vulnerability to Externalizing Disorders and Addictions) (MR/N000390/1), the Swedish Research Council FORMAS, the Medical Research Council, the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, the Bundesministeriumfür Bildung und Forschung (BMBF grants 01GS08152, 01EV0711; eMED SysAlc01ZX1311A; Forschungsnetz AERIAL 01EE1406A, 01EE1406B), the Deutsche Forschungsgemeinschaft (DFG grants, SM 80/7-2, SFB 940/2), the Medical Research Foundation and Medical Research Council (grants MR/R00465X/1 and MR/S020306/1). Further support was provided by grants from: ANR (project AF12-NEUR0008-01—WM2NA, ANR-12-SAMA-0004), the Eranet Neuron (ANR-18-NEUR00002-01), the Fondation de France (00081242), the Fondation pour la Recherche Médicale (DPA20140629802), the Mission Interministérielle de Lutte-contre-les-Drogues-et-les-Conduites-Addictives (MILDECA), the Assistance-Publique-Hôpitaux-de-Paris and INSERM (interface grant), Paris Sud University IDEX 2012, the Fondation de l'Avenir (grant AP-RM-17-013), the Fédération pour la Recherche sur le Cerveau; the National Institutes of Health, Science Foundation Ireland (16/ERCD/3797), USA (Axon, Testosterone and Mental Health during Adolescence; RO1 MH085772-01A1) and by NIH Consortium grant U54 EB020403, supported by a cross-NIH alliance that funds Big Data to Knowledge Centres of Excellence. Lifespan: The study is funded by the Research Council of Norway (230345, 288083 and 223273). NCNG: NCNG sample collection was supported by grants from the Bergen Research Foundation and the University of Bergen, the Dr Einar Martens Fund, the Research Council of Norway, to le Hellard, Steen and Espeseth. The Bergen group was supported by grants from the Western Norway Regional Health Authority (Grant 911593 to Arvid Lundervold, Grant 911397 and 911687 to Astri Johansen Lundervold). NTR: The NTR cohort was supported by the Netherlands Organization for Scientific Research (NWO) and The Netherlands Organisation for Health Research and Development (ZonMW) grants 904-61-090, 985-10-002, 912-10-020, 904-61-193, 480-04-004,463-06-001, 451-04-034, 400-05-717, Addiction-31160008, 016-115-035, 481-08-011, 056-32-010, Middelgroot-911-09-032, OCW_NWO Gravity programme—024.001.003, NWO-Groot 480-15-001/674, Center for Medical Systems Biology (CSMB, NWO Genomics), NBIC/BioAssist/RK(2008.024), Biobanking and Biomolecular Resources Research Infrastructure (BBMRI-NL, 184.021.007 and 184.033.111); Spinozapremie (NWO-56-464-14192), KNAW Academy Professor Award (PAH/6635) and University Research Fellow grant (URF) to Dorret I. Boomsma; Amsterdam Public Health research institute (former EMGO+), Neuroscience Amsterdam research institute (former NCA); the European Science Foundation (ESF, EU/QLRT-2001-01254), the European Community's Seventh Framework Programme (FP7- HEALTH-F4-2007-2013, grant 01413: ENGAGE and grant 602768: ACTION); the European Research Council (ERC Starting 284167, ERC Consolidator 771057, ERC Advanced 230374), Rutgers University Cell and DNA Repository (NIMH U24 MH068457-06), the National Institutes of Health (NIH, R01D0042157-01A1, R01MH58799-03, MH081802, DA018673, R01 DK092127-04, Grand Opportunity grants 1RC2 MH089951 and 1RC2 MH089995); the Avera Institute for Human Genetics, Sioux Falls, South Dakota (USA). Part of the genotyping and analyses were funded by the Genetic Association Information Network (GAIN) of the Foundation for the National Institutes of Health. Computing was supported by NWO through grant 2018/EW/00408559, BiG Grid, the Dutch e-Science Grid and SURFSARA. OATS: The OATS study has been funded by a National Health & Medical Research Council (NHMRC) and Australian Research Council (ARC) Strategic Award Grant of the Ageing Well, Ageing Productively Programme (ID No. 401162) and NHMRC Project Grants (ID Nos. 1045325 and 1085606). This research was facilitated through Twins Research Australia, a national resource in part supported by an NHMRC Centre for Research Excellence Grant (ID No.: 1079102). We thank the participants for their time and generosity in contributing to this research. We acknowledge the contribution of the OATS research team (https://cheba.unsw.edu.au/project/older-australian-twins-study) to this study. OATS genotyping was partly funded by a Commonwealth Scientific and Industrial Research Organization Flagship Collaboration Fund Grant. Osaka: Osaka study was supported by the Brain Mapping by Integrated Neurotechnologies for Disease Studies (Brain/MINDS: Grant Number JP18dm0207006), Brain/MINDS& beyond studies (Grant Number JP20dm0307002) and Health and Labour Sciences Research Grants for Comprehensive Research on Persons with Disabilities (Grant Number JP20dk0307081) from the Japan Agency for Medical Research and Development (AMED), Grants-in-Aid for Scientific Research (KAKENHI; Grant Numbers JP25293250 and JP16H05375). Some computations were performed at the Research Center for Computational Science, Okazaki, Japan. PAFIP: The PAFIP study was supported by Instituto de Salud Carlos III, FIS 00/3095, 01/3129, PI020499, PI060507, PI10/00183, the SENY Fundació Research Grant CI2005-0308007 and the FundaciónMarqués de Valdecilla API07/011. Biological samples from our cohort were stored at the Valdecilla Biobank and genotyping services were conducted at the Spanish 'Centro Nacional de Genotipado' (CEGEN-ISCIII). MCIC/COBRE: The study is funded by the National Institutes of Health studies R01EB006841, P20GM103472 and P30GM122734 and Department of Energy DE-FG02-99ER62764. PING: Data collection and sharing for the Paediatric Imaging, Neurocognition and Genetics (PING) Study (National Institutes of Health Grant RC2DA029475) were funded by the National Institute on Drug Abuse and the Eunice Kennedy Shriver National Institute of Child Health & Human Development. A full list of PING investigators is at http://pingstudy.ucsd.edu/investigators.html. QTIM: The QTIM study was supported by the National Institute of Child Health and Human Development (R01 HD050735) and the National Health and Medical Research Council (NHMRC 486682, 1009064), Australia. Genotyping was supported by NHMRC (389875). Medland is supported in part by an NHMRC fellowship (APP1103623). SHIP: SHIP is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant nos. 01ZZ9603, 01ZZ0103 and 01ZZ0403), the Ministry of Cultural Affairs and the Social Ministry of the Federal State of Mecklenburg-West Pomerania. Genome-wide single-nucleotide polymorphism typing in SHIP and MRI scans in SHIP and SHIP-TREND have been supported by a joint grant from Siemens Healthineers, Erlangen, Germany and the Federal State of Mecklenburg-West Pomerania. StrokeMRI: StrokeMRI was supported by the Norwegian ExtraFoundation for Health and Rehabilitation(2015/FO5146), the Research Council of Norway (249795, 262372), the South-Eastern Norway Regional Health Authority (2014097, 2015044, 2015073) and the Department of Psychology, University of Oslo. Sydney MAS: The Sydney Memory and Aging Study (Sydney MAS) is funded by National and HealthMedical Research Council (NHMRC) Programme and Project Grants (ID350833, ID568969 and ID109308). We also thank the Sydney MAS participants and the Research Team. SYS: The SYS Study is supported by Canadian Institutes of Health Research. TOP: Centre of Excellence: RCN #23273 and RCN #226971. Part of this work was performed on the TSD (Tjeneste for Sensitive Data) facilities, owned by the University of Oslo, operated and developed by the TSD service group at the University of Oslo, IT-Department (USIT) (tsd-drift@usit.uio.no). The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7-PEOPLE-2013-COFUND) under grant agreement no. 609020—Scientia Fellows; the Research Council of Norway (RCN) #276082—A lifespan perspective on mental illness: toward precision medicine using multimodal brain imaging and genetics. Ida E. Sønderby and Rune Bøen are supported by South-Eastern Norway Regional Health Authority (#2020060). Ida E. Sønderby and Ole A. Andreassen have received funding from the European Union's Horizon 2020 Research and Innovation Programme under Grant agreement no. 847776 (CoMorMent project) and the KG Jebsen Foundation (SKGJ-MED-021). UCLA_UMCU: The UCLA_UMCU cohort comprises of six studies which were supported by National Alliance for Research in Schizophrenia and Affective Disorders (NARSAD) (20244 to Prof. Hillegers), The Netherlands Organisation for Health Research and Development (ZonMw) (908-02-123 to Prof. Hulshoff Pol), and Netherlands Organisation for Scientific Research (NWO 9120818 and NWO-VIDI 917-46-370 to Prof. Hulshoff Pol). The GROUP study was funded through the Geestkracht programme of the Dutch Health Research Council (ZonMw, grant number 10-000-1001), and matching funds from participating pharmaceutical companies (Lundbeck, AstraZeneca, Eli Lilly and Janssen Cilag) and universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ inGeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord-Holland-Noord. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia Psycho-medical Center, The Hague. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGzE, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh, voor Geestelijke Gezondheid, Mondriaan, Virenzeriagg, Zuyderland GGZ, MET ggz, Universitair Centrum Sint-JozefKortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Utrecht: University Medical Center Utrecht and the mental health institutions: Altrecht, GGZ Centraal and Delta.). UK Biobank: This work made use of data sharing from UK Biobank (under project code 27412). Others: Work by Pierre Vanderhaeghen was funded by Grants of the European Research Council (ERC Adv Grant GENDEVOCORTEX), the EOS Programme, the Belgian FWO, the AXA Research Fund and the Belgian Queen Elizabeth Foundation. Ikuo K. Suzuki was supported by a postdoctoral fellowship of the FRS/FNRS. ; Peer reviewed

A key objective in the field of translational psychiatry over the past few decades has been to identify the brain correlates of major depressive disorder (MDD). Identifying measurable indicators of brain processes associated with MDD could facilitate the detection of individuals at risk, and the development of novel treatments, the monitoring of treatment effects, and predicting who might benefit most from treatments that target specific brain mechanisms. However, despite intensive neuroimaging research towards this effort, underpowered studies and a lack of reproducible findings have hindered progress. Here, we discuss the work of the ENIGMA Major Depressive Disorder (MDD) Consortium, which was established to address issues of poor replication, unreliable results, and overestimation of effect sizes in previous studies. The ENIGMA MDD Consortium currently includes data from 45 MDD study cohorts from 14 countries across six continents. The primary aim of ENIGMA MDD is to identify structural and functional brain alterations associated with MDD that can be reliably detected and replicated across cohorts worldwide. A secondary goal is to investigate how demographic, genetic, clinical, psychological, and environmental factors affect these associations. In this review, we summarize findings of the ENIGMA MDD disease working group to date and discuss future directions. We also highlight the challenges and benefits of large-scale data sharing for mental health research. ; ENIGMA MDD work is supported by NIH grants U54 EB020403 (Thompson), R01 MH116147 (Thompson), and R01 MH117601 (Jahanshad & Schmaal). LS was supported by an NHMRC Career Development Fellowship (1140764). AFFDIS cohort: this study was funded by the University Medical Center Goettingen (UMG Startfoerderung) and the research team is supported by German Federal Ministry of Education and Research (Bundesministerium fuer Bildung und Forschung, BMBF: 01 ZX 1507, "PreNeSt - e:Med"). Barcelona cohort: MJP is funded by the Ministerio de Ciencia e Innovación of the Spanish Government and by the Instituto de Salud Carlos III through a 'Miguel Servet' research contract (CP16–0020); National Research Plan (Plan Estatal de I + D + I 2016–2019); and co-financed by the European Regional Development Fund (ERDF). BRC DeCC cohort: CHYF is supported by NIHR BRC. Calgary cohort: supported by Canadian Institutes for Health Research, Branch Out Neurological Foundation. Cardiff cohort: supported by the Medical Research Council (grant G 1100629) and the National Center for Mental Health (NCMH), funded by Health Research Wales (HS/14/20). CLING cohort: this study was partially supported by the Deutsche Forschungsgemeinschaft (DFG) via grants to OG (GR1950/5–1 and GR1950/10–1). CODE cohort: Henrik Walter is supported by a grant of the Deutsche Forschungsgemeinschaft (WA 1539/4–1). The CODE cohort was collected from studies funded by Lundbeck and the German Research Foundation (WA 1539/4–1, SCHN 1205/3–1, SCHR443/11–1). DIP-Groningen cohort: this study was supported by the Gratama Foundation, the Netherlands (2012/35 to NG). Edinburgh cohort: The research leading to these results was supported by IMAGEMEND, which received funding from the European Community's Seventh Framework Programme (FP7/2007–2013) under grant agreement no. 602450. This paper reflects only the author's views and the European Union is not liable for any use that may be made of the information contained therein. This work was also supported by a Wellcome Trust Strategic Award 104036/Z/14/Z. FOR2107-Marburg cohort: funded by the German Research Foundation (DFG, grant FOR2107 KR 3822/7–2 to AK; FOR2107 KI 588/14–2 to TK and FOR2107 JA 1890/7–2 to AJ). Houston cohorts: supported in part by NIMH grant R01 085667 and the Dunn Research Foundation. JCS is supported by the Pat Rutherford, Jr. Endowed Chair in Psychiatry. IMH Study cohort: supported by funding from NHG (SIG/15012) and NMRC CISSP (2018). Melbourne cohort: funded by National Health and Medical Research Council of Australia (NHMRC) Project Grants 1064643 (Principal Investigator BJH) and 1024570 (Principal Investigator CGD). Minnesota cohort: the study was funded by the National Institute of Mental Health (K23MH090421; Dr. Cullen) and Biotechnology Research Center (P41 RR008079; Center for Magnetic Resonance Research), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, and the Minnesota Medical Foundation. This work was carried out in part using computing resources at the University of Minnesota Supercomputing Institute. Münster cohort: funded by the German Research Foundation (DFG, grant FOR2107 DA1151/5–1 and DA1151/5–2 to UD; SFB-TRR58, Projects C09 and Z02 to UD) and the Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of Münster (grant Dan3/012/17 to UD). NESDA cohort: The infrastructure for the NESDA study (www.nesda.nl) is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-Mw, grant number 10–000–1002) and is supported by participating universities (VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen) and mental health care organizations, see www.nesda.nl. Pharmo cohort: supported by ERA-NET PRIOMEDCHILD FP 6 (EU) grant 11.32050.26. PSYABM-NORMENT: supported by the Research Council of Norway (project number 229135). The South East Norway Health Authority Research Funding (project number 2015052). The Department of Psychology, University of Oslo, Norway. San Francisco cohort: supported by NIH/NCCIH 1R61AT009864–01A1. NIMH R01MH085734. SHIP and SHIP-trend cohorts: SHIP is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grants no. 01ZZ9603, 01ZZ0103, and 01ZZ0403), the Ministry of Cultural Affairs and the Social Ministry of the Federal State of Mecklenburg-West Pomerania. MRI scans in SHIP and SHIP-TREND have been supported by a joint grant from Siemens Healthineers, Erlangen, Germany and the Federal State of Mecklenburg-West Pomerania. Stanford cohorts: this work was supported by NIH grant R37 MH101495. The BiDirect Study was supported by grants from the German Federal Ministry of Education and Research (BMBF; grants FKZ-01ER0816 and FKZ-01ER1506). MDS is partially supported by an award funded by the Phyllis and Jerome Lyle Rappaport Foundation. TCH is supported by NIMH grant 5K01MH117442. EJWVS, JL, and TFB are supported by European Research Council grant no. ERC-ADG-2014–671084 INSOMNIA. TFB is supported by a VU University Amsterdam University Research Fellowship 2016–2017. JL is supported by a VU University Amsterdam University Research Fellowship 2017–2018. ; publishedVersion

This report provides a synthesis of the results of three CARISMAND Stakeholder Assemblies held in A) Bucharest,Romania on April 14-15, 2016; B) Rome,Italy on February 27-28, 2017; and C) Lisbon,Portugal on February 27-28, 2018. These Stakeholder Assemblies, together with six Citizen Summits (see Deliverables D5.3 – D5.9) were part of the CARISMAND cycle of events (see Figure 1 below). This cycle of events was the key concept at the core of the CARISMAND project which aimed to ensure a comprehensive feedback loop betweendisaster practitioners and citizens. It also allowed for the progression of ideas co-created by disaster practitioners and citizens. The locations of the three Stakeholder Assemblies were chosen due to their rather different "backgrounds". The three countries had been struck at the time of the respective event by different types of disasters. In addition, the three countries have very different "cultures", or cultural impacts, at a societal level. Romania has a comparatively strong authoritative systems due to its political history; Italy has experienced a strong direct in-flow of migrants in the last years due to its geological location; and Portugal has long been a traditional "melting pot" where, over more than a millennium, people from different cultural backgrounds and ethnic origins (in particular North Africa, South America, and Europe) have lived together. Accordingly, these differences were expected to allow a wide range of practitioners' attitudes and perceptions related to cultural factors in disaster management to emerge. In order to not only gather a variety of attitudes and perceptions but also promote cross-sectional knowledge transfer, the audience in all three events consisted of a wide range of practitioners who are typically involved in disaster management, e.g., civil protection agencies , the emergency services, paramedics, nurses, environmental protection agencies, the Red Cross, firefighters, the military, and the police. Further, these practitioners were from several regions in the respective country; in Portugal, the Stakeholder Assembly also included practitioners from the island of Madeira. The 40-60 participants per event were recruited via invitations sent to various organisations and institutions that play a role in disaster management, and via direct contacts of local partners in the CARISMAND consortium. Each assembly consisted of a mix of presentations and discussion groups to combine dissemination with information gathering (for detailed schedules see Appendices A1-A3). In an initial general assembly, the event started with presentations of the CARISMAND project and its main goals and concepts. Then, participants were split into small working groups in separate breakout rooms, where they discussed and provided feedback on a specific topic. After each working group session, panel discussions allowed the participants to present the results of their working group to the rest of the audience. After each panel discussion, keynote speakers gave presentations related to the topic that had been discussed during the working groups. This schedule was designed to ensure that participants are provided with detailed information about recent developments in disaster management, but without influencing the attitudes and perceptions expressed in the working groups. In the third Stakeholder Assembly, different sets of recommendations for practitioners (related to the use of cultural factors in disaster management) were presented to the general audience, followed by small discussion group sessions as described above. ; The project was co-funded by the European Commission within the Horizon2020 Programme (2014–2020). ; peer-reviewed

Funding Information: This study is part of the EAVE II project. EAVE II is funded by the MRC (MC_PC_19075) with the support of BREATHE—The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058). Additional support has been provided through Public Health Scotland and Scottish Government Director General Health and Social Care. The original EAVE project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (11/46/23). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or the UK government. The Brazilian component is part of the Fiocruz VigiVac project on continuous digital evaluation of the national anti-COVID-19 immunisation programme. SVK and SA acknowledge funding from an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). This partnership between Brazil and Scotland was established through funding from the NIHR (GHRG /16/137/99) using UK aid from the UK Government to support global health research. This study was partially supported by a donation from the Fazer o Bem Faz Bem programme. The authors thank DATASUS for its excellent work in providing unidentified databases. GLW, MLB, and MB-N are research fellows from the Brazilian National Research Council. GLW acknowledges funding from FAPERJ (Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro; E-26/210.180/2020). We thank Dave Kelly from Albasoft (Inverness, UK) for his support with making primary care data available; Wendy Inglis-Humphrey, Vicky Hammersley, and Laura Brook (University of Edinburgh, Edinburgh, UK); and Pam McVeigh, Amanda Burridge, and Afshin Dastafshan (Public Health Scotland, Glasgow, UK) for their support with project management and administration. Funding Information: SVK is a member of the UK Government's Scientific Advisory Group on Emergencies subgroup on ethnicity, the Cabinet Office's International Best Practice Advisory Group, and was co-chair of the Scottish Government's Expert Reference Group on Ethnicity and COVID-19. CR reports grants from the Medical Research Council (MRC) and Public Health Scotland, during the conduct of the study, and is a member of the Scottish Government Chief Medical Officer's COVID-19 Advisory Group, Scientific Pandemic Influenza Group on Modelling, and Medicines and Healthcare products Regulatory Agency Vaccine Benefit and Risk Working Group. AS is a member of the Scottish Government Chief Medical Officer's COVID-19 Advisory Group and its Standing Committee on Pandemics; he is also a member of the UK Government's New and Emerging Respiratory Virus Threats Risk Stratification Subgroup and a member of AstraZeneca's Thrombotic Thrombocytopenic Taskforce. All roles are unremunerated. VdAO, VB, MLB, and MB-N are employees of Fiocruz, a federal public institution, which manufactures Vaxzevria in Brazil, through a full technology transfer agreement with AstraZeneca. Fiocruz allocates all its manufactured products to the Ministry of Health for the public health service use. All other authors declare no competing interests. Funding Information: This study is part of the EAVE II project. EAVE II is funded by the MRC (MC_PC_19075) with the support of BREATHE?The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058). Additional support has been provided through Public Health Scotland and Scottish Government Director General Health and Social Care. The original EAVE project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (11/46/23). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or the UK government. The Brazilian component is part of the Fiocruz VigiVac project on continuous digital evaluation of the national anti-COVID-19 immunisation programme. SVK and SA acknowledge funding from an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). This partnership between Brazil and Scotland was established through funding from the NIHR (GHRG /16/137/99) using UK aid from the UK Government to support global health research. This study was partially supported by a donation from the Fazer o Bem Faz Bem programme. The authors thank DATASUS for its excellent work in providing unidentified databases. GLW, MLB, and MB-N are research fellows from the Brazilian National Research Council. GLW acknowledges funding from FAPERJ (Funda??o Carlos Chagas Filho de Amparo ? Pesquisa do Estado do Rio de Janeiro; E-26/210.180/2020). We thank Dave Kelly from Albasoft (Inverness, UK) for his support with making primary care data available; Wendy Inglis-Humphrey, Vicky Hammersley, and Laura Brook (University of Edinburgh, Edinburgh, UK); and Pam McVeigh, Amanda Burridge, and Afshin Dastafshan (Public Health Scotland, Glasgow, UK) for their support with project management and administration. Publisher Copyright: © 2022 The author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license ; Peer reviewed ; Publisher PDF

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems.

The proposed national model described in this report has been developed by a working group comprised of staff from the National Board of Health and Welfare, the National Centre for Priority Setting in Health Care, and other organisations involved in vertical prioritisation – including the Östergötland County Council, Stockholm County Council, Västra Götaland, the Health Services Region of Southern Sweden, the Swedish Society of Medicine, the Swedish Society of Nursing, and the Swedish Association of Health Professionals. Throughout the process of designing the model, the Swedish Federation of Occupational Therapists and the Swedish Association of Registered Physiotherapists were regularly informed and given opportunities to review and comment on the proposal. Furthermore, the report was reviewed and discussed at a meeting with invited representatives from the other county councils, the Pharmaceutical Benefits Board, and several professional interest groups. Viewpoints were also obtained at a seminar arranged by PrioNet, a network of individuals interested in prioritisation. Potentially, the working model described in Chapter 4 could be used in any context where vertical prioritisation takes place, e.g. activities arranged by the state, county councils, municipalities, hospital departments, and professional groups. This report is designed to be a useful tool for those working on development projects in priority setting. We believe that the contents must be adapted, with the help of relevant examples and some simplifications; to fit the specific needs of different projects or groups. The text must also be adapted to a target group's knowledge and previous experience in dealing with transparent priority setting. It must be the responsibility of each provider and other affected organisation to adapt the material to the given situation and project. The National Centre for Priority Setting in Health Care, the National Board of Health and Welfare, and others who have participated actively in this effort can be helpful to various target groups in adapting this report. When and how to engage in practically implementing vertical prioritisation are questions that need to be answered at the local level. Primarily, it is the duty of the local authorities/providers to take responsibility for implementation. Professional organisations also play an important role. Public agencies, universities, and knowledge centres should be sources of support for the local authorities/providers. The Riksdag's resolution on prioritisation served as the foundation for developing the model. Where there are areas of uncertainty in how to translate these guidelines in practice, or where practical implementation might conflict with the principles, we have pointed this out. Our conclusions and proposals are the following: When facing a choice – regardless of whether it involves allocating new resources for different purposes, or to implement cutbacks – it can be advantageous to rank the possible choices in order of priority. In our model, only the relevant options can be ranked by priority. The consequences of this ranking are not obvious at the outset, but can serve as a basis either to allocate more resources or ration by some means. In vertical prioritisation, it is advantageous to organise the prioritization process starting from a general categorisation of health problems/disease groups. As a rule, these categories cover many organisational units/clinical departments, specialties, or professional groups, thus providing a more multidimensional view of the problem. Furthermore, this allows the process to start from a patient/population perspective, which appears to be more goal-oriented than an organisational/staff perspective. That which is ranked, i.e. one of the choices, we refer to as a prioritization object. We suggest that prioritisation objects consist of different combinations of health conditions and interventions.1 When deciding on the appropriate level of detail, the decision must be based on the context in which prioritisation is carried out. A starting point would be to focus on typical cases, large-volumes services, and controversial care. All forms of vertical prioritisation should be based on the ethical principles that the Riksdag decided should apply in prioritising health services. However, these ethical principles must be made known, clarified, and perhaps complemented before they can be applied to practical priority setting. Furthermore, we believe that the Riksdag's four so-called priority groups should not be part of the model. The human dignity principle, i.e. that all people should have equal value and equal rights to care irrespective of their personal characteristics and function in society, is the undisputed cornerstone in priority setting. When personal characteristics such as age, gender, lifestyle, or function of a group are expressions of the presence of special needs, so that benefits of the interventions are different, these personal characteristics could be addressed in a priority at the group level. Further discussion is needed regarding the question of how external effects (i.e. the effects of an intervention on families and groups other than the individual directly affected by the intervention) should be valued in priority setting. The concept of need in health care includes both the severity level of the condition and the expected benefits of intervention. As a patient, one needs only those interventions that can be expected to yield benefits. Based on this definition of need, a person does not need an intervention that does not improve health and quality of life, i.e. an intervention with no benefit. In such cases, health services have a responsibility to refer people who seek care for some type of problem, to other appropriate services. The Riksdag's guidelines regarding the cost-effectiveness principle (applied to individual patients) are too limited to provide guidance for vertical prioritisation at the group level. From the outset, the Government's bill (Priority Setting in Health Care) highlighted the importance of differentiating a cost-effectiveness principle that applied to choices among various interventions for the individual patient (where the principle can be applied as the Commission of Inquiry proposed) and the aim of health services to achieve high cost-effectiveness in health care generally. Here we also refer to the Riksdag's directive to the Pharmaceutical Benefits Board. In its decisions on subsidising (prioritising) a drug, the Board should determine, e.g. whether the drug is cost effective from a societal perspective, which requires comparing the patient benefits of the drug to its cost. In such decisions, the cost effectiveness should be considered along with the needs and solidarity principle and the human dignity principle. The proposed working model essentially concurs with the working model used by the National Board of Health and Welfare in developing national guidelines. In describing a national working model, it is not possible to include every aspect that might be considered. Hence, one must start from the model and decide which other relevant aspects should be included. For instance, the International Classification on Functioning, Disability, and Health (ICF) can be used as guidance to describe the severity of health conditions. Due to the wealth of variety in outcome measures for different activities, and the limited experience in working with explicit threshold values, we believe would be premature to recommend standardised categories, e.g. risk levels. However, it is important that those working with prioritization describe their reasoning. Primarily, the categories applied by the Swedish Council on Technology Assessment in Health Care (SBU) to grade the scientific evidence of an intervention's effects should be used. Local prioritisation projects with limited resources at their disposal should describe (text) their appraisal of the scientific evidence and reference the scientific sources used. The strength of evidence should be expressed in numbers only when supporting a conclusion of a systematic review by SBU, or other literature reviews of good quality. Prioritisation projects having access to health economic evaluation should, until further notice, adhere to the approach used by the National Board of Health and Welfare and present cost-effectiveness on a scale from low to very high cost per life-year gained or cost per quality-adjusted life-year. Economic evidence should be presented according to the principles applied by the National Board of Health and Welfare. In local projects with limited resources, or problems in consistently acquiring information on cost effectiveness, we recommend that the authors at least discuss cost effectiveness in cases where the priority ranking would be decisively affected when costs are weighed in. A 10-level ranking list should be used. The ranking list should be complemented by a "don't do" list for methods that should not be used at all, or not used routinely, and a research and development (R&D) list for methods where the evidence still insufficient to motivate their use in standard practice. In the absence of an objective quantitative/mathematical method, a qualitative method should be used in the appraisal. Here too, we believe that it is not yet possible to establish standard criteria to determine within which ranking level a prioritisation object should fall. Results should be presented as a ranking list. The parameters used as a basis for prioritisation should also be presented in a uniform manner in ranking lists that are shared with other parties. For pedagogic reasons, details concerning language and format need to be adapted to the respective target groups. Thresholds for what constitutes an acceptable coverage of need (care quality, volume, and percentage of the patient group with access to services) are regional and local issues, and hence are not included in the national model.

This literature review on Early Childhood Education (ECE)/Inclusive Early Childhood Education (IECE) is part of the 'Inclusive Early Childhood Education' project, conducted by the European Agency for Special Needs and Inclusive Education. The project's overall goal is to identify and analyse the factors that enable quality and effective pre-primary programmes for all children in inclusive early years settings. This review shows that international organisations and the European Union (EU) regard high-quality ECE/IECE as an essential foundation for lifelong learning. It is indispensable for success in modern knowledge-based economies. Participation in high-quality pre- primary education has long-lasting positive effects on children's development and the benefits are greater for children from a disadvantaged background (Frawley, 2014). In many cases, the early childhood stage is critical because many children's different needs are detected once they become part of the education system. Therefore, one EU benchmark in the strategic framework for European co-operation in education and training (ET 2020) is that at least 95% of children between the age of four and compulsory school age should participate in ECE. At the same time, there are concerns about the accessibility and quality of ECE/IECE provisions. Despite its importance – especially considering the latest data about provisions for children with special educational needs (SEN) and/or at risk of social exclusion (e.g. due to poverty) in Europe from birth to seven years – the Organisation for Economic Co-operation and Development (OECD, 2004) reports that only one quarter of children with SEN are included in mainstream early education settings. This literature review aims to: • collect information about at-risk children and/or children with SEN in Europe at the pre-primary education level; • describe where those children are located during the pre-primary stages; • explore which resources are allocated to meet their needs; • describe the main characteristics of the educational contexts where these children are included. This document summarises major research and policy documents to analyse Early Childhood Education and Care (ECEC) services and programmes implemented for at-risk children and/or those with SEN. Chapter 2 introduces the definitions of the concepts that are the focus of study. Chapter 3 summarises the main documents published by international organisations and reviews the main EU policy developments related to ECE/IECE which define the context in this area. Chapter 4 reviews the latest literature describing the benefits of ECE/IECE for at-risk children and children with SEN. Chapters 5 to 10 describe relevant academic research, aiming to identify the main factors that are important in early years programmes. The key research is framed within the five principles identified by the European Commission's Thematic Working Group on ECEC (2014), namely: • Access/transition procedures • Workforce • Curriculum/content • Governance/funding • Monitoring/evaluation. ; peer-reviewed

Die kumulative Dissertation besteht aus insgesamt acht Artikeln, die im Rahmen des Projektes "Services for Supporting Family Carers of Elderly People in Europe: Characteristics, Coverage and Usage (EUROFAMCARE)" im fünften Forschungsrahmenprogramm der Europäischen Union in der Sektion "Quality of Life and Management of Living Resources" entstanden sind. Wissenschaftler aus insgesamt 23 Ländern beschäftigten sich in diesem Forschungsverbund mit der Lebenssituation betreuender Angehöriger älterer Menschen. In sechs dieser 23 Länder wurden jeweils ca. 1.000 betreuende Angehörige von Familienmitgliedern, die 65 Jahre oder älter und für mindestens vier Stunden pro Woche auf die persönliche Unterstützung ihres Angehörigen angewiesen waren, persönlich interviewt. Der Autor war in diesem Projekt wissenschaftlicher Mitarbeiter und Projekt Manager im Koordinationszentrum, das im Hamburger Institut für Medizin-Soziologie am Universitätsklinikum Hamburg-Eppendorf angesiedelt war. Das Projekt wurde von der Leiterin der AG Sozialgerontologie, Frau Dr. Hanneli Döhner, koordiniert. Eine inhaltliche Einführung liefert eine Kurzübersicht des Themas "familiale Unterstützung von älteren hilfebedürftigen Menschen" unter Berücksichtigung des demografischen Wandels und seiner sozial- und gesundheitspolitischen Implikationen – und beleuchtet die große Bedeutung der primärsozialen Netzwerke im Kontext der gesundheitlichen Versorgung sowie die komplexen und teils hohen Anforderungen an die Betreuungspersonen. Es folgt eine Übersicht zur Zusammenstellung dieser Dissertation sowie einen Projektbeschreibung, die auch Informationen zur Entstehungsgeschichte, den Rahmenbedingungen, den beteiligten Partnern sowie den Anteilen des Autors an den jeweiligen Artikeln beinhaltet. Bei den darauffolgenden ersten fünf Artikeln handelt es sich um Buchpublikationen, die inhaltliche und methodische Aspekte des Projektes wiedergeben. So enthält der erste Artikel "Introduction - Aims and Structure of the EUROFAMCARE Project" eine Übersicht zu den Zielen und zum Aufbau des Projektes. Der zweite Artikel "Issues and Challenges in Carer Support: A Consideration of the Literature" enthält eine Literaturübersicht zum Thema "pflegende Angehörige älterer Menschen" auf internationaler Ebene, gefolgt von einer auf Deutschland bezogenen Literaturübersicht in Artikel drei "Literature - State of the Art". Der vierte Beitrag "Motive von Angehörigen, ihre älteren Familienmitglieder zu betreuen" beinhaltet eine Analyse der im Projekt erhobenen Motive der betreuenden Angehörigen, ihre älteren Familienmitglieder zu unterstützen und zu pflegen, und beleuchtet damit bedeutsame Variablen hinsichtlich der Betreuungsbereitschaft und möglicher auslösender Rahmenbedingungen. Eine projektübergreifende Zusammenfassung der zentralen Ergebnisse der sechs Länder-Studien liefert der fünfte Artikel "Summary of Main Findings from the Trans-European Survey Report". Diesen fünf Buchpublikationen folgen drei Artikel, die nach einem Begutachtungsverfahren durch jeweils zwei unabhängige Gutachter in medizin-psychologischen und pflegewissenschaftlichen Fachzeitschriften publiziert wurden. Der sechste Artikel "Familiale Pflege älterer Menschen in Europa unter einer Geschlechterperspektive" analysiert auf der Basis einer Literaturrecherche und des europäischen EUROFAMCARE-Datensatzes die Gemeinsamkeiten und Unterschiede von pflegenden Männern und Frauen in Bezug auf ihre Lebensqualität, empfundene Belastung, Nutzung von externer Unterstützung und den mit Pflege und Betreuung assoziierten Implikationen auf die berufliche Situation. Der siebte Artikel "Zu den Unterschieden und Gemeinsamkeiten von pflegenden Ehepartnern und anderen pflegenden Angehörigen in der deutschen Teilstudie des Projektes EUROFAMCARE" zeigt, dass das Verwandtschaftsverhältnis – hier unterschieden nach Ehepartnern/Lebensgefährten vs Kindern und Schwiegerkindern vs der Gruppe "Angehörige 2. Grades und Freunde/Bekannte" – eine Variable darstellt, die in einem signifikanten Zusammenhang mit Betreuungsbereitschaft einerseits und erlebter Konsequenzen (Belastung, Lebensqualität, Hilfeersuchen etc.) andererseits steht. Der abschließende achte Artikel "Der Einfluss von Betreuungsbedarf und psychosozialen Determinanten auf Belastung und Wohlbefinden von pflegenden Angehörigen alter Menschen" differenziert zwischen verschiedenen Variablen, die die Betreuungs- und Pflegesituation mit Bezug auf die daraus resultierende Beeinflussung von Lebensqualität und empfundener Belastung determinieren. Hier zeigt sich insbesondere bei vorliegenden Verhaltensauffälligkeiten – meist als Symptom demenzieller Erkrankungen – ein Effekt auf Belastung und Lebensqualität, aber auch ein signifikanter kompensierender Effekt durch die Variable "soziale Unterstützung". Die sich anschließende Diskussion geht artikelübergreifend und zusammenfassend auf begriffliche und methodische Aspekte des Projekts und dieser Dissertation ein. ; This thesis is based on the project "Services for Supporting Family Carers of Elderly People in Europe: Characteristics, Coverage and Usage (EUROFAMCARE)" within the European Union 5th Framework Program, section "Quality of Life and Management of Living Resources". The thesis consists of eight publications embedded in an introduction and a concluding discussion. All in all researchers of 23 European countries have analysed the situation of family carers of older people. Six of these countries have conducted in-depths studies each with around 1,000 personally interviewed family carers of those family members who were 65 years or above and in need of personal support for at least four hours a week. In this project the author was engaged both as a researcher and the project manager at the co-ordinating centre in the Department of Medical Sociology at the University Medical Center Hamburg-Eppendorf. The project has been co-ordinated by Dr. Hanneli Döhner, head of the working group on social gerontology. The Introduction reflects the issue of family care of dependent older people in the framework of demographic change and social and health policies. Furthermore, it highlights the outstanding importance of primary social networks in the context of health care as well as the complex and partly distressing demands on family caregivers. It is followed by an overview on the structure of the thesis and an overview on the European project including its history, its framework, the partners involved and the author's role in this development. The following first five publications are book chapters dealing with content and methodological issues. Thus, the first is about "Introduction - Aims and Structure of the EUROFAMCARE Project", the second on international literature ("Issues and Challenges in Carer Support: A Consideration of the Literature"), and the third on literature on the national level of Germany ("Literature - State of the Art"). The fourth article is focussing on motives of family carers to provide support and care for their relatives. It provides an analysis of different motives we have gathered in the interviews, and reflects important variables concerning the will of family members to care and the given circumstances. At fifth, a "Summary of Main Findings from the Trans-European Survey Report" describes the central outcomes of the six-country study of EUROFAMCARE. The five book chapters are followed by three peer-reviewed papers in medical-psychological and nursing science journals. The sixth article is about gender-related aspects of family care in Europe. It analyses similarities and differences of women and men in their role as family carers on the basis of both a literature review and analyses of the European data set of EUROFAMCARE with respect for their quality of life, perceived burden, use of external support services, and care associated implications on their job careers. The seventh article is dealing with similarities and differences of and between different degrees of relationship to the person in need of support. Three groups were analysed: spouses, children and children-in-law as well as 2nd-degree-relatives and friends or neighbours. A significant correlation was found between a "closer" degree of relationship and the willingness to care, but also with perceived burden and reduced quality of life. The article eight is about the influence of care needs and psychosocial determinants on burden and well-being of family carers of older people. In this paper it is shown that specifically behavioural problems of the cared-for – mostly as symptoms of dementia or dementia related diseases – have a significant effect on well-being and perceived burden, but also that social support has a significant compensating effect. Finally, a discussion and conclusion is summarising terminological and methodological aspects and limitations of the study and this thesis.