Earliest evidence of human occupations and technological complexity above the 45th North parallel in Western Europe. The site of Lunery-Rosieres la-Terre-des-Sablons (France, 1.1 Ma).

The site of LuneryRosieres la-Terre-des-Sablons (Lunery, Cher, France) comprises early evidence of human occupation in mid-latitudes in Western Europe. It demonstrates hominin presence in the Loire River Basin during the Early Pleistocene at the transition between an interglacial stage and the beginning of the following glacial stage. Three archaeological levels sandwiched and associated with two diamicton levels deposited on the downcutting river floor indicate repeated temporary occupations. Lithic material yields evidence of simple and more complex core technologies on local Jurassic siliceous rocks and Oligocene millstone. Hominins availed of natural stone morphologies to produce flakes with limited preparation. Some cores show centripetal management and a partially prepared striking platform. The mean ESR age of 1175 ka ± 98 ka obtained on fluvial sediments overlying the archaeological levels could correspond to the transition between marine isotopic stages (MIS) 37 and 36, during the normal Cobb Mountain subchron, and in particular at the beginning of MIS 36. The Lunery site shows that hominins were capable of adapting to early glacial environmental conditions and adopting appropriate strategies for settling in mid-latitude zones. These areas cannot be considered as inhospitable at that time as Lunery lies at some distance from the forming ice cap.

Epidemiology and demographic patterns of cardiovascular diseases and neoplasms deaths in Western Europe: a 1990-2019 analysis.

OBJECTIVES: Cardiovascular diseases (CVDs) and neoplasms have been considered as public health concerns worldwide. This study aimed to estimate the epidemiological patterns of death burden on CVDs and neoplasms and its attributable risk factors in Western Europe from 1990 to 2019 to discuss the potential causes of the disparities. STUDY DESIGN AND METHODS: We collected data on CVDs and neoplasms deaths in 24 Western European countries from the Global Burden of Disease Study. We analyzed patterns by age, sex, country, and associated risk factors. The results include percentages of total deaths, age-standardized death rates per 100,000 population, and uncertainty intervals (UIs). Time trends were assessed using annual percent change. RESULTS: In 2019, CVDs and neoplasms accounted for 33.54% and 30.15% of Western Europe's total deaths, with age-standardized death rates of 128.05 (95% UI: 135.37, 113.02) and 137.51 (95% UI: 142.54, 128.01) per 100,000. Over 1990-2019, CVDs rates decreased by 54.97%, and neoplasms rates decreased by 19.54%. Top CVDs subtypes were ischemic heart disease and stroke; top cancers for neoplasms were lung and colorectal. Highest CVD death burdens were in Finland, Greece, Austria; neoplasm burdens in Monaco, San Marino, Andorra. The major risk factors were metabolic (CVDs) and behavioral (neoplasms). Gender differences revealed higher CVDs death burden in males, while neoplasms burden varied by risk factors and age groups. CONCLUSION: In 2019, CVDs and neoplasms posed significant health risks in Western Europe, with variations in death burdens and risk factors across genders, age groups, and countries. Future interventions should target vulnerable groups to lessen the impact of CVDs and neoplasms in the region.

The health state of France before COVID-19 pandemic between 1990 and 2019: an analysis of the Global Burden of Disease study 2019.

Background: France faces nowadays some major challenges regarding its health care system including medically underserved areas, social health inequalities, and hospital pressures. Various indicators and sources of data allow us to describe the health status of a population and, consequently, to assess the impact of these challenges. We assessed the burden of diseases before COVID-19 in France in 2019 and its evolution from 1990 to 2019, and compared it with Western European countries. Methods: We used specific Global Burden of Diseases (GBD) metrics: socio-demographic index (SDI), life expectancy (LE), healthy life expectancy (HALE), years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) with their 95% uncertainty interval (95% UI). We compared French age-standardized metrics to those for other Western European Countries for both sexes and also between 1990 and 2019. We also described the specific causes of these different metrics. Findings: We observed for life expectancy at birth in France a trend to an improvement over time from 77.2 (95% UI: 77.2-77.3) years in 1990 to 82.9 (82.7-83.1) in 2019, which represented the seventh highest life expectancy among 23 Western European countries. HALE at birth in France increased from 67.0 (64.0-69.7) to 71.5 (68.1-74.5), which represented the fourth highest HALE among 23 Western European countries. In France, the total number of DALY per 100.000 population tended to decrease from 25,192 (22,374-28,351) in 1990 to 18,782 (16,408-21,920) in 2019. As compared to other European countries, the burden due to cardiovascular diseases was lower. Neoplasms and cardio-vascular diseases were the two leading causes of YLLs. Mental and musculoskeletal disorders were the two leading causes of YLDs. Interpretation: Overall, these results highlight a clear trend of improvement in the health status in France with certain differences between western European countries. The health policy makers need to devise interventional strategies to reduce the burden of diseases and injuries, with specific attention to causes such as cancers, cardiovascular diseases, mental health and musculoskeletal disorders. Funding: Bill & Melinda Gates Foundation.

The Grandchildren of Immigrants in Western Europe: Patterns of Assimilation Among the Emerging Third Generation.

Migration scholars have long regarded the trajectory of the third generation as a critical test of assimilation; however, scholarship to date has been limited and largely focused on socioeconomic attainment. In this article, we rely on a large dataset of adolescent respondents in England, Germany, and the Netherlands to compare the second and third generations in terms of their social networks and cultural identities. The third generation shows stronger ties to the native fourth-plus generation alongside weaker ties to coethnics. We document comparable, albeit more moderate, dynamics of assimilation over generations in regard to national and ethnic identification, along with substantial variation by country of destination and ethnic origin group. Our results point to a dominant trend of assimilation at the third generation and suggest future challenges to provide a more durable assessment of postwar migration waves two generations after settlement.

Adherence and Persistence to Basal Insulin Among People with Type 2 Diabetes in Europe: A Systematic Literature Review and Meta-analysis.

INTRODUCTION: Diabetes is associated with a number of complications, particularly if glycaemic targets are not achieved. Glycaemic control is highly linked to treatment persistence and adherence. To understand the burden of poor persistence and adherence, this systematic literature review identified existing evidence regarding basal insulin adherence/non-adherence and persistence/non-persistence among people with diabetes in Western Europe (defined as the UK, France, Spain, Switzerland, the Netherlands, Ireland, Austria, Portugal, Denmark, Norway, Sweden, Finland, Italy, Germany, Iceland and Belgium). METHODS: Eligible studies were systematically identified from two databases, Medline and Embase (published between 2012 and June 2022). Conference abstracts from ISPOR and EASD were manually included. Identified studies were screened by two independent reviewers in a two-step blinded process. The eligibility of studies was decided on the basis of pre-established criteria. A proportional meta-analysis and comparative narrative analyses were conducted to analyse the included studies. RESULTS: Twelve studies were identified. Proportions of adherence/non-adherence and persistence/non-persistence varied across studies. Pooled rates of non-persistence at 6, 12 and 18 months were 20.3% (95% CI 13.8; 27.8), 33.8% (95% CI 24.1; 44.3) and 36.5% (95% CI 33.6; 39.4), respectively. In the literature, the proportion of adherent people ranged from 41% to 64% (using the outcome measure medication possession ratio (MPR) > 80%), with a pooled rate of 55.6% (95% CI 45.3; 65.6), suggesting that approximately 44% of people with type 2 diabetes (T2D) are non-adherent. CONCLUSION: The results highlight that almost half of patients with T2D in Western Europe have poor adherence to insulin therapy and, at 18 months, one in three patients do not persist on treatment. These findings call for new basal insulin therapies and diabetes management strategies that can improve treatment persistence and adherence among people with T2D.

Differences of corruption types in selected Western and central-eastern health systems during the COVID-19 pandemic: a rapid review.

Objectives: To identify, describe, and classify the cases of health corruption present in selected Western [the Netherlands and the United Kingdom (UK)] and Central-Eastern European (Poland and Slovakia) countries during the COVID-19 pandemic. Methods: A rapid review of the literature was conducted, evaluating data from 11 March 2020 to 15 April 2021. Information sources included MEDLINE via WoS, IBSS via ProQuest, Scopus, and gray literature. Results: Thirteen cases were identified across the four countries. The primary type of health corruption in Western European countries was procurement corruption, while misuse of (high) level positions was the most prevalent in Central-Eastern European countries. Actors from central governments were most involved in cases. The rule of law and anti-corruption watchdogs reported most cases in the United Kingdom and the Netherlands, while the media reported cases in Poland and Slovakia. Conclusion: The differences in types of corruption in WE and CEE countries emphasize the need to contextualize the approach to tackle corruption. Thus, further research in preventing and tackling corruption is a vital and necessary undertaking despite the inherent of conducting health corruption research.

Analysis of variation characteristics, transport paths, and influencing factors of atmospheric NO2 pollution in Western Europe.

Climate change and air pollution are one of the global environmental problems. It is significant to grasp the air pollution situation of Western Europe in recent 10 years for its or the global pollution control. Based on the OMI tropospheric nitrogen dioxide (NO2) column density data, the spatial and temporal distribution characteristics, variation trend, transmission path, and influencing factors of NO2 in 15 countries in Western Europe from 2011 to 2022 are discussed in this paper. Meanwhile, the annual average spatial and temporal distribution in 2023 is predicted by the random forest (RF) model. The results showed that (1) the 12-year spatial distribution map showed an increasing trend from southwest to northeast, with the border area of the Netherlands and Germany and Milan as two high-value areas, and the overall trend over time was that the high-concentration area gradually shrank, the low-concentration area gradually expanded, and the annual average concentration gradually decreased. (2) The inter-month trend presents a "U" shape, with the mean NO2 pollution ranking in winter > autumn > spring > summer. (3) Natural factors are one of the reasons affecting NO2; for instance, NO2 pollution has a strong positive correlation with the lifted index, relative humidity, and wind speed and a moderately strong negative correlation with precipitable water and air temperature. (4) Exogenous atmospheric transport is another important factor affecting the change of NO2 pollution in Western Europe. The HYSPLIT model is used to analyze the backward trajectory of Milan, Italy, and Nijmegen, Netherlands, in the four seasons of 2022. Both are mainly influenced by westerly airflows, and therefore, the transport effect in the atmosphere brings air pollutants from westerly regions in the atmosphere.

Autonomy Over Independence: Self-Determination in Catalonia, Flanders and South Tyrol in the Aftermath of the Great War.

The end of the First World War was a crucial time for nationalist leaders and minority communities across the European continent and beyond. The impact of the post-war spread of self-determination on the redrawing of Eastern European borders and on the claims of colonial independence movements has been extensively researched. By contrast, the international historiography has paid little attention to minority nationalist movements in Western Europe. This article focuses on three regions (Catalonia, Flanders and South Tyrol) that experienced considerable sub-state national mobilization in the interwar period. We aim to understand whether the leaders of Western European minorities and stateless nations shared the same enthusiasm as their anti-colonial and Eastern European counterparts for the new international order that self-determination seemed to foreshadow in the months following the end of the First World War. Because the American President Woodrow Wilson stood out as the most prominent purveyor of the new international legitimacy of self-determination, the article further examines how Western European nationalist movements exploited Wilson's image and advocacy to achieve their own goals. Nationalist forces in Catalonia, Flanders and South Tyrol initially mobilized self-determination and referred to Wilson as a symbol of national liberation, but this instrumentalization of self-determination was not sustained. Large-scale mobilization occurred only in Catalonia, and, even there, it disappeared suddenly in spring 1919. Furthermore, sub-state nationalist movements in Western Europe tended to mobilize self-determination to gain regional autonomy, rather than full independence, thus pursuing internal, not external, self-determination. The willingness of these movements to privilege autonomy over full independence made them more receptive to compromise. Radical forces would become stronger only in the 1930s and largely for reasons not directly connected to the post-war mobilization around self-determination.

Addressing violence against children: A systematic review on interventions to accelerate the achievement of the UN sustainable development goal in Europe and Africa.

BACKGROUND: Violence against children (VAC) is a global public health issue. In the context of limited resources, the United Nations Development Programme has coined the concept of a Sustainable Development Goals (SDG) accelerator for preventing and responding to VAC. An 'accelerator' is a provision that simultaneously leads to progress across multiple SDGs targets and goals. OBJECTIVES: This systematic review synthesizes the literature on violence prevention evaluation studies using robust methods according to the SDG accelerator framework for children aged 0-18 in Western Europe and Central and West Africa. It also provides a lens for analyzing research inequities between the global North and South, examining the challenges and differences undermining knowledge production across regions, particularly in research output. METHOD: We systematically searched 30 electronic databases and grey literature in English and French. The quality of included studies was assessed using the Cochrane Risk of Bias tool. RESULTS: Nine evaluation studies related to four SDG goals and ten targets were included in the analysis. As a result, no intervention was identified as an accelerator for children in West and Central Africa. In contrast, three promising interventions were identified as accelerators in Western Europe. Two school-based interventions reduce bullying, depression, and substance abuse and improve psychological well-being; and one home-based intervention reduces child abuse, the severity of neglect, and mental health problems and improves school attendance. Moreover, this review also uncovered a lack of research from the Global South that points to serious disadvantages for authors and institutions and global violence prevention efforts, as it hinders the flow of knowledge and innovative practices. CONCLUSIONS: The results highlight the need for future VAC prevention trials to integrate the SDG accelerators concept further. Additionally, more effort should be made to support scholars in the global South to address knowledge inequities and to enhance understanding of how accelerators work in different field settings and conditions. This effort will ensure that interventions accelerate SDG goals and impact the world's most vulnerable children.

In vitro activity of ceftolozane/tazobactam against multidrug-resistant Pseudomonas aeruginosa from patients in Western Europe: SMART 2017-2020.

Multidrug-resistant (MDR) Pseudomonas aeruginosa infections compromise both empirical and definitive antimicrobial therapies. The Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance program identified 943 MDR P. aeruginosa (from a total of 4086 P. aeruginosa isolates [23.1%]) collected at 32 clinical laboratories in six countries in Western Europe from 2017 to 2020. Minimum inhibitory concentrations (MICs) for ceftolozane/tazobactam and 10 comparator agents were determined by broth microdilution and interpreted using 2021 EUCAST breakpoints. ß-lactamase genes were identified in selected isolate subsets. Most isolates of P. aeruginosa in Western Europe (93.3%) were ceftolozane/tazobactam-susceptible. A total of 23.1% of P. aeruginosa isolates were MDR. Of these, 72.0% were ceftolozane/tazobactam-susceptible, which is similar to that for ceftazidime/avibactam (73.6%) but >40% higher than for carbapenems, piperacillin/tazobactam, third- and fourth-generation cephalosporins, and levofloxacin. Metallo-ß-lactamases (MBLs) were carried by 8.8% of molecularly characterized MDR P. aeruginosa, and 7.6% of molecularly characterized MDR isolates carried Guiana Extended Spectrum (GES) carbapenemases. MBLs were identified in isolates from all six countries, ranging from 3.2% of all P. aeruginosa isolates from Italy to 0.4% of all isolates from the United Kingdom. Acquired ß-lactamases were not identified in 80.0% of molecularly characterized MDR P. aeruginosa isolates. Percentages of MDR isolates without detected ß-lactamases were higher in the United Kingdom (97.7%), Spain (88.2%), France (88.1%), and Germany (84.7%) than in Portugal (63.0%) and Italy (61.3%), where carbapenemases were more prevalent. Ceftolozane/tazobactam is an important treatment option for patients infected with MDR P. aeruginosa that are not susceptible to first-line antipseudomonal agents.

In vitro activity of imipenem/relebactam against piperacillin/tazobactam-resistant and meropenem-resistant non-Morganellaceae Enterobacterales and Pseudomonas aeruginosa collected from patients with bloodstream, intra-abdominal and urinary tract infections in Western Europe: SMART 2018-2020.

Introduction. Piperacillin/tazobactam and carbapenems are important agents for the treatment of serious Gram-negative infections in hospitalized patients. Resistance to both agents is a significant concern in clinical isolates of Enterobacterales and Pseudomonas aeruginosa; new agents with improved activity are needed.Gap Statement. Publication of current, region-specific data describing the in vitro activity of newer agents such as imipenem/relebactam (IMR) against piperacillin/tazobactam-resistant and carbapenem-resistant Enterobacterales and P. aeruginosa are needed to support their clinical use.Aim. To describe the in vitro activity of IMR against non-Morganellaceae Enterobacterales (NME) and P. aeruginosa isolated from bloodstream, intra-abdominal and urinary tract infection samples by hospital laboratories in Western Europe with a focus on the activity of IMR against piperacillin/tazobactam-resistant and meropenem-resistant isolates.Methodology. From 2018 to 2020, 29 hospital laboratories in six countries in Western Europe participated in the SMART global surveillance programme and contributed 9487 NME and 1004 P. aeruginosa isolates. MICs were determined by CLSI broth microdilution testing and interpreted by EUCAST (2021) breakpoints. ß-Lactamase genes were identified in selected isolate subsets (2018-2020) and oprD sequenced in molecularly characterized P. aeruginosa (2020).Results. IMR (99.4 % susceptible), amikacin (98.0 %), meropenem (97.7 %) and imipenem (97.6 %) were the most active agents against NME; 83.1 % of NME were piperacillin/tazobactam-susceptible. Relebactam increased imipenem susceptibility of NME from Italy by 8.3 %, from Portugal by 2.9 %, and from France, Germany, Spain and the UK by <1 %. In total, 96.4 % of piperacillin/tazobactam-resistant (n=1601) and 73.7 % of meropenem-resistant (n=152) NME were IMR-susceptible. Also, 0.4 % of NME were MBL-positive, 0.9 % OXA-48-like-positive (MBL-negative) and 1.5 % KPC-positive (MBL-negative). Amikacin (95.4 % susceptible) and IMR (94.1 %) were the most active agents against P. aeruginosa; 81.7 % of isolates were imipenem-susceptible and 79.6 % were piperacillin/tazobactam-susceptible. Relebactam increased susceptibility to imipenem by 12.5 % overall (range by country, 4.3-17.5 %); and by 30.7 % in piperacillin/tazobactam-resistant and 24.3 % in meropenem-resistant P. aeruginosa. In total, 1.6 % of P. aeruginosa isolates were MBL-positive. Seven of eight molecularly characterized IMR-resistant P. aeruginosa isolates from 2020 were oprD-deficient.Conclusion. IMR may be a potential treatment option for bloodstream, intra-abdominal and urinary tract infections caused by NME and P. aeruginosa in Western Europe, including infections caused by piperacillin/tazobactam-resistant and meropenem-resistant isolates.

Does economic policy uncertainty impact firms' capital structure policy? Evidence from Western European economies.

This study specifically investigates the impact of economic policy uncertainty (EPU) on travel and leisure (TL) companies' debt holdings policy. To the best of our knowledge, there is a momentous gap in exclusively conducting the impact of EPU on the debt holdings policy behavior of Western European firms operating in the TL sector and its sub-sectors, namely the airlines, gambling, hotels, recreational services, restaurants and bars, and travel and tourism. In this sector, external financing is strongly needed to finance enormous investments and replace, expand, and modernize tangible and intangible assets. To fill the gap, the present study selects 92 publicly listed TL companies operating in Western Europe's top tourist destinations, namely, the UK, Germany, France, Spain, and Italy, and performs both the static and dynamic panel data estimation approaches during the 2005-2019 period. The results reveal that the EPU negatively impacts TL firms' debt holdings, implying that firms tend to decline in debt levels by rising EPU. Consequently, the results highlight that the level of EPU matters, and firms' debt ratios are relatively lower in countries having a higher EPU and vice versa. Besides, the results underscore that the EPU negatively impacts firms' debt holdings in each sub-sector; however, the negative effect is most prominent on the debt ratios of the firms, particularly those operating in gambling, hotels, travel, and tourism, and also recreational services sub-sectors. The results are robust and have important suggestions for regulatory bodies, policymakers, and firms' managers.

The Burden of Type 1 and Type 2 Diabetes Among Adolescents and Young Adults in 24 Western European Countries, 1990-2019: Results From the Global Burden of Disease Study 2019.

Objectives: As little is known about the burden of type 1 (T1DM) and type 2 diabetes (T2DM) in adolescents in Western Europe (WE), we aimed to explore their epidemiology among 10-24 year-olds. Methods: Estimates were retrieved from the Global Burden of Diseases Study (GBD) 2019. We reported counts, rates per 100,000 population, and percentage changes from 1990 to 2019 for prevalence, incidence and years lived with disability (YLDs) of T1DM and T2DM, and the burden of T2DM in YLDs attributable to high body mass index (HBMI), for 24 WE countries. Results: In 2019, prevalence and disability estimates were higher for T1DM than T2DM among 10-24 years old adolescents in WE. However, T2DM showed a greater increase in prevalence and disability than T1DM in the 30 years observation period in all WE countries. Prevalence increased with age, while only minor differences were observed between sexes. Conclusion: Our findings highlight the substantial burden posed by DM in WE among adolescents. Health system responses are needed for transition services, data collection systems, education, and obesity prevention.

Local People Standings on Existing Farm Animal Welfare Legislation in the BRIC Countries and the USA. Comparison with Western European Legislation.

This study explored the demand for improved farm animal welfare (FAW) legislation in the BRIC countries and the USA. Results are discussed in comparison to Europe. Interviewees ranked their willingness to support or oppose introduction of more FAW-friendly laws in their country. A multinomial logistic regression was fit to the data (p < 0.001), with the parameters "country × gender" (p < 0.001) and "country × age" (p < 0.001) found significant. Americans, Russian women, and older Brazilian men are very supportive. The age effect is also felt in India, where older people are more supportive. Chinese, American men, and younger Indians are less supportive. Russian males are the group that oppose the most, followed by younger Brazilians and Indians. The law and its application vary a lot between countries. Nevertheless, the societal willingness to improve FAW legislation is high in all countries. The willingness is higher in Europe. The different cultural backgrounds, the socio-economic factors, and the social, economic, and environmental sustainability are enough reasons to create barriers to policy harmonization in the global trade of farm animal products.

Changes in the number of healthcare professionals in European healthcare systems between 2000 and 2018 / Az egészségügyi szakdolgozók létszámváltozása az európai egészségügyi rendszerekben 2000 és 2018 között

Introduction: Ensuring the supply of healthcare professionals is an important health policy issue nowadays. Objective: The aim of our research is to provide a comprehensive picture of the health workforce situation in the European OECD countries. Data and methods: Indicators analyzed regarding the numbers of practising midwives, nurses, physiotherapists and total hospital beds were derived from the "OECD Health Statistics 2021" database for the period 2000­2018. 24 European OECD countries were grouped according to the type of healthcare system and geographical location. Data were subsequently compared by parametric and nonparametric tests, focusing especially on years 2000, 2010, 2018. Results: Between 2000 and 2018, there was a 14% increase in the average number of midwives, a 30% increase in the average number of nurses, and a 41% increase in the average number of physiotherapists per 100,000 population in the OECD countries examined. Per 100 hospital beds, the average number of midwives increased by 72%, the number of nurses by 86%, and the number of physiotherapists by 97%. Significant results for all three years analyzed were obtained in the number of physiotherapists per 100 hospital beds (p = 0.014; p<0.001; p = 0.002) when comparing the Western and Eastern European countries examined. As for the healthcare systems, significant results were obtained only in the number of nurses per 100 hospital beds for the year 2010 (p = 0.048). Conclusion: Among healthcare professional groups, the number of physiotherapists increased the most in Europe. The numbers of healthcare professionals per 100 beds are significantly higher in Western European countries analyzed compared to Eastern European countries.

Changes in the Number of Physicians and Hospital Bed Capacity in Europe.

OBJECTIVES: Our aim was to examine the numbers of practicing physicians and total numbers of hospital beds in European Organisation for Economic Co-operation and Development countries. METHODS: Data analyzed were derived from the "Organisation for Economic Co-operation and Development Health Statistics 2020" database between 1980 and 2018. The selected countries were compared according to the type of healthcare system and geographical location by parametric and nonparametric tests. RESULTS: In 1980, Bismarck-type systems showed an average number of physicians of 2.3 persons/1000 population; in Beveridge-type systems, it was 1.7 persons. By 2018, it leveled out reaching 3.9 persons in both healthcare system types. In 1980, average physician number/1000 was 2.5 persons in Eastern Europe; in Western Europe, it was 1.9 persons. By 2018 this proportion changed with Western Europe having the higher number (3.7 persons; 3.9 persons). In 1980, average number of hospital beds/1000 population was 9.6 in Bismarck-type systems whereas in Beveridge-type systems it was 8.8. By 2018, it decreased to 5.6 in Bismarck-type systems (-42%) and to 3.1 in Beveridge-type systems (-65%). In 1980, the average number of hospital beds/1000 population in Eastern Europe was 10.3; in Western Europe, it was 8.5. By 2018, the difference between the 2 regions did not change. CONCLUSIONS: Although the number of physicians was 33% higher in 1980 in Eastern Europe than in Western Europe, by 2018 the number of physicians was 5% higher in Western Europe. In general, regardless of the healthcare system and geographical location, the proportion of physicians per 1000 population has improved due to a larger decrease in the number of hospital beds.

Recommendations to Improve Tick-Borne Encephalitis Surveillance and Vaccine Uptake in Europe.

There has been an increase in reported TBE cases in Europe since 2015, reaching a peak in some countries in 2020, highlighting the need for better management of TBE risk in Europe. TBE surveillance is currently limited, in part, due to varying diagnostic guidelines, access to testing, and awareness of TBE. Consequently, TBE prevalence is underestimated and vaccination recommendations inadequate. TBE vaccine uptake is unsatisfactory in many TBE-endemic European countries. This review summarizes the findings of a scientific workshop of experts to improve TBE surveillance and vaccine uptake in Europe. Strategies to improve TBE surveillance and vaccine uptake should focus on: aligning diagnostic criteria and testing across Europe; expanding current vaccine recommendations and reducing their complexity; and increasing public education of the potential risks posed by TBEV infection.

Sergei Yudin (1891-1954) y la transfusión de sangre cadavérica. Sus repercusiones en Europa occidental / Sergei Yudin (1891-1954) and the cadaveric blood transfusion. It’s repercussions in Western Europe

Este trabajo tiene como principal objetivo rescatar del olvido la historia de las transfusiones de sangre cadavérica y la figura de su principal artífice, Sergei Yudin. Para ello, se lleva a cabo una revisión sistemática de fuentes bibliográficas en diferentes idiomas para describir su trayectoria vital y su obra científica. La idea partió de las experiencias transfusionales en perros de Vladimir Shamov y fue desarrollada clínicamente a partir de 1930 por Yudin en el Instituto Sklifosovsky de Medicina de Emergencia de Moscú, donde se realizaron transfusiones de sangre cadavérica humana de manera regular durante cuatro décadas. La conservación de esta sangre durante varias semanas permitió la creación del primer banco de sangre en el mundo y fue el punto de partida de los trasplantes clínicos, considerando que la sangre es un tejido especial. A finales de los años veinte y principios de los treinta, Yudin viajó a Alemania, Francia, España e Inglaterra y gozó de gran prestigio entre los círculos médicos internacionales, incluidos los catalanes y españoles. El curso de su vida fue azaroso, pasando de ser el cirujano más prestigioso de la Unión Soviética al ostracismo tras ser encarcelado en 1948 y posteriormente desterrado a Siberia.

This work aims to rescue from oblivion the history of cadaveric blood transfusions and the figure of its main protagonist, Sergei Yudin. For this reason, an extensive review of bibliographic sources in Russian and other languages is carried out to describe Yudin’s life trajectory and his scientific work. The idea originated from Vladimir Shamov’s transfusion experiences in dogs and started clinically in 1930 by Yudin at the Sklifosovsky Institute of Emergency Medicine in Moscow, where human cadaveric blood transfusions were performed on a regular basis for four decades. The conservation of this blood for several weeks allowed the creation of the first blood bank in the world and was the starting point of clinical transplants, considering that blood is a special tissue. In the late 1920s and early 1930s, Yudin traveled to Germany, France, Spain and England and enjoyed great prestige in international medical circles, including Catalan and Spanish. The course of his life was arduous, going from being the most prestigious surgeon in the Soviet Union to ostracism after being imprisoned in 1948 and later exiled to Siberia.

Tobacco Use Among People Incarcerated in Western Europe: A Systematic Review and Meta-analysis.

Background: Evidence suggests that the prevalence of tobacco use has declined significantly in the general population but still remains high among people incarcerated in high-income countries. Tobacco use is the second leading risk factor of mortality and morbidity worldwide. The objective of this study is to synthesize evidence on the prevalence of smoking among people incarcerated in Western European countries. Methods: We searched the PubMed database for articles published between June 2010 and June 2020, website of international organizations and hand-searching references. One author reviewed studies that met pre-defined inclusion criteria, and this was cross-validated by a second reviewer, following the MOOSE guidelines. The Meta prop command of Stata (V16) was used for pooling smoking prevalence estimates. Random effects modelling, heterogeneity with subgroup analysis and publication bias was assessed. Results: Out the 236 identified articles, 25 with full texts were eligible, and 16 were finally included in this study. The overall pooled estimate of smoking prevalence was 72.3%, 95% CI (54.8-84.7), and high heterogeneity (I2 = 99.73%). Females had a pooled prevalence 44.1% (95% CI 9.4-82.6) while males 83.3% (95% CI 72.0-92.1). The total number of prisoners combined in this study was 16,435 (ranging from 31-21,451) with age ranging from 24-43 years. Conclusion: A relatively high smoking rate was observed among incarcerated people - higher among the male population. The study findings are useful for informing policy-makers of the existing burden of smoking in special vulnerable populations across Western Europe-and the need for comprehensive tobacco control policies in different population settings.

Medical Pluralism in East and West Europe: A Comparison of People Visiting Healthcare Practitioners Specializing in Complementary and Alternative Medicine.

BACKGROUND: Interest in various forms of complementary and alternative medicine (CAM) (e.g., naturopathy, homeopathy, traditional Chinese medicine, osteopathy, and chiropractic) is continuing to grow throughout Europe. Very little is known as to whether the prevalence and patterns of CAM usage are another cross-cutting phenomenon, dividing Europe, or whether they indicate homogenous healthcare settings throughout the continent. By examining data from the general population, the main objective of the study is to conduct a cross-country comparison of medical pluralism in Eastern and Western European countries. METHODS: The cross-country comparison was conducted using data obtained through the International Social Survey Programme (ISSP). Data addressing healthcare issues were last collected for the ISSP in 2011. By analysing existing similarities and/or differences in the prevalence of sociodemographic and socioeconomic determinants, which could encourage visits to complementary and alternative practitioners, data from 21 European societies only were included. In addition, the aim was to investigate whether individuals' scarcity of trust in physicians, as well as a lack of confidence in healthcare systems, may explain visits to CAM practitioners across Europe. RESULTS: While in Eastern countries, a total of 531 (5.5%) respondents reported a visit to/by a CAM healthcare practitioner during the preceding 12 months, in Western Europe, a visit to/by a CAM healthcare practitioner was reported by 11.6% of individuals. In Western Europe, the use of CAM is most prevalent among younger generations of women, those of a lower socioeconomic position and/or with a low level of trust in conventional doctors. In Eastern Europe, CAM practitioners are mainly visited by older generations, city dwellers of a higher socioeconomic position and with a relatively high level of trust in physicians. CONCLUSION: After collating data from 21 societies, the study concludes that more than three decades after the collapse of the socialist experiment in Eastern Europe, there is evidence that the European continent remains divided in relation to the alternative healthcare sector. The field of non-conventional healthcare represents an indicator supporting the existence of a dividing line between Eastern and Western Europe.