European Council Recommendation Research Articles

The Ticking Time Bomb in the European Union Has Exploded: The Importance of European Council Recommendations on the Healthcare Workforce

The Ticking Time Bomb in the European Union Has Exploded: The Importance of European Council Recommendations on the Healthcare Workforce

Key issues that need to be considered while revising the current annex of the European Council Recommendation (2003) on cancer screening.

The 2003 European Council recommendation urging the Member States to introduce or scale up breast, cervical and colorectal cancer screening through an organized population-based approach has had a remarkable impact. We argue that the recommendation needs to be updated for at least two sets of reasons. First, some of the current clinical guidelines include new tests or protocols that were not available at the time of the Council document. Some have already been adopted by organized screening programs, such as newly defined age ranges for mammography screening, Human Papillomavirus (HPV)-based cervical cancer screening, fecal immunochemical test (FIT) and sigmoidoscopy for colorectal cancer screening. Second, the outcomes of randomized trials evaluating screening for lung and prostate cancer have been published recently and the balance between harms and benefits needs to be pragmatically assessed. In the European Union, research collaboration and networking to exchange and develop best practices should be regularly supported by the European Commission. Integration between primary and secondary preventive strategies through comprehensive approaches is necessary not only to maximize the reduction in cancer burden but also to control the rising trend of other noncommunicable diseases sharing the same risk factors.

Exposure and health risks perception of extremely low frequency and radiofrequency electromagnetic fields and the effect of providing information

Given that regardless of actual exposure levels, high-risk perceptions of electromagnetic fields of non-ionizing radiation (EMF-NIR) may cause health effects, it is important to understand the mechanisms behind perceptions in the general population. The aims of this study were to assess perceptions of both exposure and health-risk among mothers of the INMA (Environment and childhood)-Gipuzkoa child cohort; to explore possible determinants that explain such perceptions; and to evaluate whether providing information on exposure levels has any effect on perceptions. Overall, 387 mothers completed a questionnaire composed of four questions on perceived exposure and perceived health-risk of exposure to extremely low frequency (ELF) and radiofrequency (RF) fields answered on a Likert-type scale from 0 to 10. Later, measurements of ELF and RF fields were conducted in the houses of a subsample of 104 participants. All measured levels were far below the levels established by the European Council recommendation. This was explained in the individual reports sent to the families. After reading the results, mothers completed the aforementioned questionnaire a second time, plus two additional questions regarding the role of public health bodies in risk communication.The association between perceived and measured levels as categorical variables was assessed with a chi-square test. Multiple linear regressions were conducted for each of the questions related to perceived exposure and health-risk perceptions. Wilcoxon signed-rank test was conducted to assess the effect of receiving information.Both exposure and health risk were perceived to be very high for both ELF and RF fields, with mean and medians of 7 on a 10-point scale. Reporting higher perception levels was not associated with higher levels of exposure measured at home. Variables that were repeatedly associated with higher perceptions included: manual social class, not having the feeling of living in a good neighborhood, difficulty getting by financially, not having a television antenna within 600 m, being younger and having fewer devices at home. Providing information on EMF-NIR exposure levels at home did not alter health-risk perceptions, but mean perceived RF exposure decreased significantly (by 0.7 points). Most of the participants claimed to have received no or insufficient information regarding exposure and health-risks of EMF-NIR from public bodies and considered it very important that they should.

“Assessment in Dialogue” (AID). Assessing the Communicative Action

“Assessment in Dialogue” (AID) is a model of Joanna Piasta-Siechowicz addressed to the participants of general education: students-teachers-parents. AID reconciles contradictory tendencies of the philosophy and praxis of student assessment: the pursuit of objectivity of the former and the need of individualisation of the latter. It aspires to combine the objectivity of requirements and evaluation criteria with the need of individualisation. It is also well suited to help teachers in systematic planning of their work. “Assessment in Dialogue” refers to the trisubjectivity (student-parent-teacher) in the planning and organisation of student’s activities and, as a result, in informing about his/her achievements during a lesson. Implemented in a primary school since 2012, “Assessment in Dialogue” is popularised at conferences of principals and teachers in Poland and Ireland, workshops for teachers, publications in methodical journals. It is grounded in the official documents of the Ministry of National Education, European Council recommendations and conclusions from ten years of constant evaluation of the psycho-didactic process in schools as well as the functioning of evaluation system in Poland.

ELF in English language teaching: Researching attitudes of Serbian academic community

The aim of the empirical part of the research was to explore the attitude of the Serbian academic community towards the English language used as lingua franca (ELF), i.e. neutral variety of the English language. The results might be a starting point in considering whether to include ELF in the language policy and, consequently, into English curricula in Serbia. The research included members of Serbian academic community, students of different departments, and English language teachers in the state owned and privately owned universities in Belgrade, Novi Sad and Nis. After examining their attitudes towards key postulates of ELF the conclusions are that it is necessary to start discussions about the concepts of the variety and to reassess current deeply rooted ideas about the English language from the perspective of modern linguistic trends. The need for a more liberal approach to the variety is not generated only in the needs of the market, i.e. those people to whom English is a practical means of international communication, but also the need to adjust ELT (English Language Teaching) to modern linguistic tendencies and the European Council recommendations.

The EU youth guarantee – a critical analysis of its implementation in Spain

ABSTRACTThe significant increase in youth unemployment in different parts of Europe caused by the economic crisis has led to the European Council Recommendation on Establishing a Youth Guarantee (2013). This Guarantee addresses the so-called ‘NEET’ (Not in Education, Employment, or Training) younger than 25 years of age and stipulates that employment, education or training shall be provided within a period of 4 months. As the initiative is relatively recent, in-depth analyses of its contents and implantation in the Member States are still missing. This paper analyses the European Recommendation and its implementation in Spain, evaluating its potential to improve the situation of the young people and society as a whole and its risks in provoking undesired side-effects. Our results question if the whole target group will be reached and highlight the measures’ low potential to promote a real and durable change. Increasing precariousness and insecurity and the tendency to only redistribute existing labour make it conceivable that the Guarantee may contribute to converting precariousness into a new labour paradigm for the whole population. The insufficient and retroactive funding of the Youth Guarantee can provoke negative side-effects for other social policies and the country's development. We conclude with several recommendations on how to improve the Youth Guarantee and its implementation.

Unpacking commercial sector opposition to European smoke-free policy: lack of unity, ‘fear of association’ and harm reduction debates

ObjectiveTobacco companies have made extensive efforts to build alliances against comprehensive smoke-free legislation. This article analyses the interaction between actors who opposed the development of the European Council Recommendation on...

Tobacco Control and Health Advocacy in the European Union: Understanding Effective Coalition-Building.

Introduction:Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood.Methods:Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy.Results:An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance’s success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders.Conclusions:The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health.

European Initiatives In Quality Management Of Systems For Education And Training

AbstractEuropean initiatives on quality education started in higher education and vocational education and training. Objectives: Identification of the main EU initiatives in quality assurance; Analyzing the stage of applying the European Parliament and Council Recommendation on the European constitution European Framework of Reference for Quality Assurance in Education and Training; There were studied the official EU documents and other papers in the subject matter. Intermediate results show:It is necessary to ensure inter-comparability of educational systems, using indicators and through the establishment and adherence to common principles of quality assurance in education. Implications of the European approach is to develop national quality assurance systems.

Seasonal influenza immunisation in Europe. Overview of recommendations and vaccination coverage for three seasons: pre-pandemic (2008/09), pandemic (2009/10) and post-pandemic (2010/11)

Since 2008, annual surveys of influenza vaccination policies, practices and coverage have been undertaken in 29 European Union (EU)/ European Economic Area (EEA) countries. After 2009, this monitored the impact of European Council recommendation to increase vaccination coverage to 75% among risk groups. This paper summarises the results of three seasonal influenza seasons: 2008/09, 2009/10 and 2010/11. In 2008/09, 27/29 countries completed the survey; in 2009/10 and 2010/11, 28/29 completed it. All or almost all countries recommended vaccination of older people (defined as those aged ≥50, ≥55, ≥59, ≥60 or ≥65 years), and people aged ≥6 months with clinical risk and healthcare workers. A total of 23 countries provided vaccination coverage data for older people, but only 7 and 10 had data for the clinical risk groups and healthcare workers, respectively. The number of countries recommending vaccination for some or all pregnant women increased from 10 in 2008/09 to 22 in 2010/11. Only three countries could report coverage among pregnant women. Seasonal influenza vaccination coverage during and after the pandemic season in older people and clinical groups remained unchanged in countries with higher coverage. However, small decreases were seen in most countries during this period. The results of the surveys indicate that most EU/EEA countries recommend influenza vaccination for the main target groups; however, only a few countries have achieved the target of 75% coverage among risk groups. Coverage among healthcare workers remained low.

European Strategies to Control Antibiotic Resistance and Use

Europe has taken many political actions since 1999 to better control antimicrobial resistance and use, including two European Council Recommendations and actions taken by numerous European Union (EU) presidencies. These presidencies triggered many public health and research actions in the EU. Europe developed several very successful surveillance programmes on antimicrobial resistance and antimicrobial use, both currently coordinated by the European Centre for Disease Prevention and Control (ECDC). These surveillance programmes were able to identify emerging problems of antibiotic resistance and targets for quality improvement of antimicrobial use; they also conducted impact assessments of campaigns to reduce antibiotic use and increase hand hygiene. The public antibiotic awareness campaigns were very successful in reducing antibiotic use and resistance in countries like Belgium and France. The successes of these campaigns inspired ECDC to launch an annual European Antibiotic Awareness Day on November 18, 2008. The hand hygiene campaigns resulted in a dramatic decrease of MRSA infections in many EU Member States. However, ESBLproducing Gram-negative bacteria and Carbapenemresistant Enterobacteriaceae and non-fermenters are increasing in most EU countries. Finally, the EU is investing hundreds of millions of EUROs in a Public Private Partnership (PPP), called the Innovative Medicines Initiative (IMI). An important initiative of IMI is the launch of the Combating Antibiotic Resistance NewDrugs4BadBugs programme. The goal of this new research programme is to create an innovative and collaborative PPP-based approach that will positively impact all aspects of the antimicrobial resistance issue, from the discovery of novel products to Phase 1-3 clinical trials. (Ann Clin Microbiol 2014;17:1-8)

Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Electromagnetic field exposure assessment in Europe radiofrequency fields (10 MHz–6 GHz)

Average levels of exposure to radiofrequency (RF) electromagnetic fields (EMFs) of the general public in Europe are difficult to summarize, as exposure levels have been reported differently in those studies in which they have been measured, and a large proportion of reported measurements were very low, sometimes falling below detection limits of the equipment used. The goal of this paper is to present an overview of the scientific literature on RF EMF exposure in Europe and to characterize exposure within the European population. A comparative analysis of the results of spot or long-term RF EMF measurements in the EU indicated that mean electric field strengths were between 0.08 V/m and 1.8 V/m. The overwhelming majority of measured mean electric field strengths were <1 V/m. It is estimated that <1% were above 6 V/m and <0.1% were above 20 V/m. No exposure levels exceeding European Council recommendations were identified in these surveys. Most population exposures from signals of radio and television broadcast towers were observed to be weak because these transmitters are usually far away from exposed individuals and are spatially sparsely distributed. On the other hand, the contribution made to RF exposure from wireless telecommunications technology is continuously increasing and its contribution was above 60% of the total exposure. According to the European exposure assessment studies identified, three population exposure categories (intermittent variable partial body exposure, intermittent variable low-level whole-body (WB) exposure and continuous low-level WB exposure) were recognized by the authors as informative for possible future risk assessment.

Implementation of evidence-based interventions to prevent drowning: results from a WHO collaborative project

Introduction34 000 drowning-related deaths are observed yearly in WHO European Region. Rates in low- and middle-income countries are six times higher than in high-income countries.MethodsA questionnaire survey was undertaken as...

Progress in preventing injuries: an online inventory of national policies

IntroductionAs part of a 3-year collaborative project between WHO and the European Commission on progress achieved by Member States in implementing resolution EUR/RC55/R9 and the European Council Recommendation on the...

Progress in preventing injuries: from international collaboration to local implementation

IntroductionInjuries and violence are the third leading cause of death in WHO European Region and pose a threat to economic and social development.Aim and methodsThe results of a 3-year collaborative...

Cervical Cancer Assessment in Romania under EUROCHIP-2

Inside the European project EUROCHIP-2, the Romania team has ruled out an assessment study regarding cervical cancer screening programs (CCS) in Romania, in Nov 2006-March 2007. The general purpose was to be aliened to European Council recommendations that states that an organized cervical screening program should be offered in all member states, in order to reduce the specific incidence and mortality. The aim of the study was to assess cervical cancer burden and current cervical cancer screening status in Romania and in various sub-regions (DR), and also to identify problems and barriers and to propose solutions for implementing an organized cervical cancer screening program at national level. The study was based on a statistical survey and a comprehensive literature review of the most important European, national and regional papers or studies completed in this field. Over 2000-2006, a total number of 22,830 new cases and 12,763 deaths from cervical cancer was registered in Romania. In 2005, the crude rate of incidence varied largely in the 8 DR between 17.8-31.3 and mortality varied between 12.3-21.5. The proportion of women tested by DRs on total female population varied between 3.2%-0.6%; the highest screening activity was observed in region VI, where run the only organized CCS in Romania. In 2005, there were one GP per 578 female population aged 25-65; regarding the specialists in 2007 per country we had: 3,012 women aged 25-65 per one gynecologist, 21,195 women per one oncologist and 13,258 women per one histopathologist. There were no major changes in policy screening over 2000-2006 correlated with no major difference in specific mortality in Romania. Significant differences in incidence and mortality between DRs were observed in 2005, which impose deeper analyzes of local conditions and resources and local strategies to be adopted. The burden of cervical cancer is particularly high in Romania and is related to the absence of an organized CCS program or the ineffectiveness of the opportunistic screening programs. It is needed that European Council recommendations be implemented and quality assurance strategies to be checked and maintained at all screening levels in Romania.

Shaping comprehensive policies for injury prevention in Europe

Injuries, whether intentional or unintentional, are the third leading cause of death in the WHO European Region and pose a threat to economic and social development. Comprehensive policies for injury prevention are a means of organising the actions of different stakeholders and sectors towards achieving the shared objective of preventing injuries. In Europe, the development of comprehensive national policies is advocated by both the WHO Regional Committee resolution EUR/RC55/R9 and the European Council Recommendation on the prevention of injuries and promotion of safety. This article presents an overview of progress achieved by European Member States in implementing these policy recommendations, and some more general reflection on the challenges and opportunities faced in preventing injuries and violence in the Europe. Much progress has been made, with the development of national policies for preventing individual types of injury and violence ranging from 86% for road safety to about one third for preventing youth violence and self-inflicted violence. Countries were assessed as to whether they were implementing any of 69 evidence-based injury and violence prevention programmes selected from the literature. Progress in implementing these varied in different countries, and the median was 56% for the 31 responding countries taken together. Although overall encouraging progress is taking place, the health sector needs to commit more to the widespread implementation of effective programmes, and to engage with other stakeholders in a multisectoral response to prevent injuries. This should include the development of an overarching strategic framework for action, as well as the development of strong evidence-based arguments towards making injury prevention a compelling case for policy makers to act upon, particularly in view of the large gap in safety inequality uncovered by research.

Exposure of the general public due to wireless LAN applications in public places

The typical exposure caused by wireless LAN applications in public areas has been investigated in a variety of scenarios. Small-sized (internet café) and large-scale (airport) indoor scenarios as well as outdoor scenarios in the environment of access points (AP) supplying for residential areas and public places were considered. The exposure assessment was carried out by numerical GTD/UTD computations based on optical wave propagation, as well as by verifying frequency selective measurements in the considered scenarios under real life conditions. In the small-sized indoor scenario the maximum temporal peak values of power density, spatially averaged over body dimensions, were found to be lower than 20 mW/m(2), corresponding to 0.2% of the reference level according to the European Council Recommendation 1999/519/EC. Local peak values of power density might be 1-2 orders of magnitude higher, spatial and time-averaged values for usual data traffic conditions might be 2-3 orders of magnitude lower, depending on the actual data traffic. In the considered outdoor scenarios, exposure was several orders of magnitude lower than in indoor scenarios due to the usually larger distances to the AP antennas.