Involvement In Europe Research Articles

Variations in reporting of nurse involvement in end-of-life practices in intensive care units worldwide (ETHICUS-2): A prospective observational study

BackgroundICU nurses are most frequently at the patient's bedside, providing care for both patients and family members. They perform an essential role and are involved in decision-making. Despite this, research suggests that nurses have a limited role in the end-of-life decision-making process and are occasionally not involved. ObjectiveExplore global ICU nurse involvement in end of life decisions based on the physician's perceptions and sub-analyses from the ETHICUS-2 study. DesignThis is a secondary analysis of a prospective multinational, observational study of the ETHICUS-2 study. SettingEnd of life decision-making processes in ICU patients were studied during a 6-month period between Sept 1, 2015, and Sept 30, 2016, in 199 ICUs in 36 countries. InterventionNone. MethodsThe ETHICUS II study instrument contained 20 questions. This sub-analysis addressed the four questions related to nurse involvement in end-of-life decision-making: Who initiated the end-of-life discussion? Was withholding or withdrawing treatment discussed with nurses? Was a nurse involved in making the end-of-life decision? Was there agreement between physicians and nurses? These 4 questions are the basis for our analysis. Global regions were compared. ResultsPhysicians completed 91.8 % of the data entry. A statistically significant difference was found between regions (p < 0.001) with Northern Europe and Australia/New Zealand having the most discussion with nurses and Latin America, Africa, Asia and North America the least. The percentages of end-of-life decisions in which nurses were involved ranged between 3 and 44 %. These differences were statistically significant. Agreement between physicians and nurses related to decisions resulted in a wide range of responses (27–86 %) (p < 0.001). There was a wide range of those who replied “not applicable” to the question of agreement between physicians and nurses on EOL decisions (0–41 %). ConclusionThere is large variability in nurse involvement in end-of-life decision-making in the ICU. The most concerning findings were that in some regions, according to physicians, nurses were not involved in EOL decisions and did not initiate the decision-making process. There is a need to develop the collaboration between nurses and physicians. Nurses have valuable contributions for best possible patient-centered decisions and should be respected as important parts of the interdisciplinary team. Tweetable abstractWide global differences were found in nurse end of life decision involvement, with low involvement in North and South America and Africa and higher involvement in Europe and Australia/New Zealand.

6.M. Workshop: Private equity investment in Europe’s primary care sector

Abstract This workshop explores the growing role of private equity funds in Europe's primary care sector. Based on a rapid response report of the European Observatory on Health Systems to the French National Health Insurance Fund (Caisse nationale de l’assurance maladie, CNAM), it offers a platform for sharing examples from across Europe, facilitating cross-country learning through country presentations and audience participation. Private equity investments in Europe’ health sector have increased exponentially in recent years, including in primary care, but this trend has so far received very little attention. This is surprising, as this development has the potential to change the healthcare landscape in Europe dramatically. The short investment and resale horizon of private equity funds and the emergence of practice chains and monopolistic structures are of particular concern. Ultimately, the growing private equity involvement in Europe's primary care sector could undermine equitable access to health care, reduce physicians’ autonomy, affect local or regional cooperation, erode data protection and raise health care costs. However, private equity investments may also be associated with benefits, such as providing needed capital or enabling employment for young physicians who want to work part-time or do not want to run a practice as entrepreneur. So far, there is little transparent information on ownership structures and very little research on the impact of private equity investments on outcomes, such as equity, access and quality of care. This workshop aims to provide a snapshot of trends in Europe and to inform current debates on how regulators should best respond. It provides an overview of the situation in four European countries (Germany, the Netherlands, Ireland and Sweden) and of policy responses so far. The workshop will provide opportunity for the audience to comment on and discuss the country presentations, share experience in their own countries, and consider policy options in Europe to improve transparency on ownership structures and ensure the interests of patients, the public, and health workers are protected. The workshop will be of interest to researchers, practitioners and policy-makers working on primary care in Europe. Key messages • The workshop provides a forum for discussing the growing role of private equity investment in Europe's primary care sector. • It explores regulatory options to safeguard the interests of patients, health workers and the public.

Fathers in Europe: Policies, constructions and practices. Introduction to the Special Collection

Objective: To introduce the readers to the Journal of Family Research’s Special Collection about fatherhood-related political frameworks, social constructions of fatherhood and masculinity, and practices of fathers in Europe. Background: Fatherhood research has proliferated in recent decades and reflects that paternal involvement is closely linked to national policies, to prevailing social normative understandings of fatherhood, and also varies in practice. Method: Except for the review article, the contributions of this Special Collection draw on empirical data, including quantitative analyses of large-scale data, such as the European Social Survey, the QUIDAN-Survey, and the DJI “Growing up in Germany” survey, and qualitative analyses of in-depth interviews. Results: The six contributions vary in focus and illustrate a wide range of approaches to the understanding of fatherhood constructions and practices as well as the political frameworks that shape contemporary fatherhood in Europe. The contributions study fatherhood in the context of the transition to parenthood, parenting practices, the composition of working environments as well as in social work practice. Conclusion: The discussion of fatherhood constructions and practices as well as related political frameworks is crucial to understanding which social conditions facilitate and hinder father involvement in Europe.

Inpatient Specialist Palliative Care in Patients With Left Ventricular Assist Devices (LVAD): A Retrospective Case Series.

BackgroundRepeat hospitalizations, complications, and psychosocial burdens are common in patients with left ventricular assist devices (LVAD). Specialist palliative care (sPC) involvement supports patients during decision-making until end-of-life. In the United States, guidelines recommend early specialist palliative care (esPC) involvement prior to implantation. Yet, data about sPC and esPC involvement in Europe are scarce.Materials and MethodsThis is a retrospective descriptive study of deceased LVAD patients who had received sPC during their LVAD-related admissions to two university hospitals in Duesseldorf, Germany and Basel, Switzerland from 2010 to 2021. The main objectives were to assess: To which extent have LVAD patients received sPC, how early is sPC involved? What are the characteristics of those, how did sPC take place and what are key challenges in end-of-life care?ResultsIn total, 288 patients were implanted with a LVAD, including 31 who received sPC (11%). Twenty-two deceased LVAD patients (19 male) with sPC were included. Mean patient age at the time of implantation was 67 (range 49–79) years. Thirteen patients (59%) received LVAD as destination therapy, eight patients (36%) were implanted as bridge to transplantation (BTT), and one as an emergency LVAD after cardiogenic shock (5%). None of the eight BTT patients received a heart transplantation before dying. Most (n = 13) patients lived with their family and mean Eastern Cooperative Oncology Group (ECOG) performance status was three. Mean time between LVAD implantation and first sPC contact was 1.71 years, with a range of first sPC contact from 49 days prior to implantation to more than 6 years after. Two patients received esPC before implantation. In Duesseldorf, mean time between first sPC contact and in-hospital death was 10.2 (1–42) days. In Basel, patients died 16 (0.7–44) months after first sPC contact, only one died on the external sPC unit. Based on thorough examination of two case reports, we describe key challenges of sPC in LVAD patients including the necessity for sPC expertise, ethical and communicative issues as well as the available resources in this setting.ConclusionDespite unequivocal recommendations for sPC in LVAD patients, the integration of sPC for these patients is yet not well established.

The evolving practice of patient and public involvement in Europe and the United States

Patient and public involvement (PPI) in academic human research has been evolving in the United States and Europe since the early 1980s, when it was jump-started by activists responding to the HIV pandemic. This article provides a brief look at the development of PPI in academic human research in the US and Europe, highlights the PPI initiatives of several US and European organisations, discusses how PPI is gaining momentum in health technology assessment bodies, and provides recommendations for various stakeholders on how to incorporate more PPI into academic human research.

Examining the relationship between impaired driving and past crash involvement in Europe: Insights from the ESRA study

Driving under the influence of alcohol, drugs and fatigue are all important factors of crash causation. Exploring the link between driver attitudes and crash involvement provides understanding on these important issues. To that end, questionnaire answers of car drivers disclosing their attitudes on the impacts of driving under the influence of alcohol, drugs and fatigue, and their relationship with past crash involvement as car drivers were analysed. A two-step approach is adopted: Principal Component Analysis (PCA) was employed to consolidate relative questions in numeric factor quantities. Afterwards, binary logistic regression was implemented on the calculated component scores to determine the impact of perspectives of road users for each factor on past crash involvement of car drivers. Data from the international ESRA2015 survey were utilized. PCA indicated that it is possible to meaningfully merge 29 ESRA2015 questions relevant to driving under the influence of alcohol, drugs and fatigue into 8 informative components accounting for an adequate percentage of variance. Binary logistic analysis indicated that components involving overall personal and communal acceptance of impaired driving, overall and past year personal behaviour towards impaired driving and frequency of typical journey checks by traffic police were all quantities positively correlated with past crash involvement.

Civic and Political Engagement during the Multifaceted COVID-19 Crisis.

Measures to cope with the COVID‐19 pandemic have put a sudden halt to street protests and other forms of citizen involvement in Europe. At the same time, the pandemic has increased the need for solidarity, motivating citizens to become involved on behalf of people at risk and the vulnerable more generally. This research note empirically examines the tension between the demobilisation and activation potential of the COVID‐19 crisis. Drawing on original survey data from seven Western European countries, we examine the extent, forms, and drivers of citizens’ engagement. Our findings show the remarkable persistence of pre‐existing political and civic engagement patterns. Concurrently, we show that threat perceptions triggered by the multifaceted COVID‐19 crisis have mobilized Europeans in the early phase of the pandemic. Similarly, the role of extreme ideological orientations in explaining (regular) political engagement indicates that the current situation may create its specific mobilisation potentials.

The AgTech Startup Perspective to Farmers Ex Ante Acceptance Process of Autonomous Field Robots

Autonomous vehicles not only provide a new impetus in the development of car models in the automotive industry—even in agriculture there has recently been talk of autonomous field robots (AFR). Great expectations are placed on these digital assistants from a wide variety of perspectives. However, it is still unclear whether they will make the transition from market niches to broad-based distribution. Apart from various factors, this depends on user acceptance of this new technology expected by the innovators, since this is likely to be essential for the further development of AFR. For this purpose, the ex ante user acceptance of farmers from the perspective of various AgTech startups with AFR involvement in Europe was investigated in this exploratory and qualitative study. The Technology Acceptance Model (TAM) served as the basis for the developed interview guideline. In summary, the results confirm that a variety of factors potentially influence farmer acceptance and AFR diffusion from the perspective of AgTech startups, with perceived usefulness being considered the main motivation for using AFR. The interviewed experts believe that AFR will initially be used in crops that have relatively high costs for crop protection treatments before becoming economically attractive for other crops. The basic prerequisite for a successful market launch is an adjustment of the legal framework, which sets standards in relation to AFR and thus, provides security in the production process. The results could support political decision-makers in dealing with this new technology and AFR manufacturers in the promotion of AFR.

The Notorious Ben Hecht: Iconoclastic Writer and Militant Zionist by Julien Gorbach

Reviewed by: The Notorious Ben Hecht: Iconoclastic Writer and Militant Zionist by Julien Gorbach Rafael Medoff (bio) The Notorious Ben Hecht: Iconoclastic Writer and Militant Zionist. By Julien Gorbach. West Lafayette, IN: Purdue University Press, 2019. xxiii + 453 pp. Interwar Hollywood had more than its share of Jewish actors who changed their names and Jewish producers who steered clear of content that might draw attention to their ethnicity. In the early stages of his public career, Ben Hecht, the columnist, novelist and playwright turned screenwriter, seemed to be cut from the same cloth, or worse. His 1931 novel A Jew in Love was awash in stereotypes so grotesque that one prominent critic called the main character "the caricature of the anti-Semite come to life." In reality, Julien Gorbach contends in The Notorious Ben Hecht, he was just "parodying the un-Jewish Jew" (8). Not many people seemed to get the joke. "Outrage cascaded like an avalanche from some quarters of the American Jewish community," Gorbach reports. Rabbis in Cleveland declared they would never allow Hecht to be buried in their city. Hecht replied that he was not troubled to miss out on "an honor nobody I know has ever yearned for" (97). In fact, he seemed to revel in the tumult that his writings often provoked. So how did the iconoclast known for writing the scripts for such blockbusters as Gone With the Wind and The Front Page become a notorious Zionist militant? Hecht's transformation evidently had nothing to do with Judaism or Jewish culture, not his immigrant parents nor his boisterously ethnic extended family. He changed because the world had changed. Hecht looked around in 1939 and was horrified to see Jews around the world under siege and most American Jews seemingly hesitant to respond. Many had "discarded their Jewishness out of the belief that as Jews they could line up only for a snubbing," Hecht wrote (118). His instincts—honed as a gritty crime reporter on the streets of early 1900s Chicago—told him that the Jews needed to answer their persecutors with "a battle cry, rather than moans" (164). In this thoroughly-researched and finely-written study—the first comprehensive scholarly biography of Hecht—Gorbach adeptly chronicles the stages of Hecht's political evolution. It began with his decision to join the Fight for Freedom committee, which on the eve of World War II urged preemptive American military action against Nazi Germany. Polls showed the public overwhelmingly opposed to US involvement in Europe's conflicts, but Hecht never minded being in the minority. Using his dramatist's skills to make his case, Hecht created Fun to Be Free, a three-hour "Mammoth Revue" of patriotic songs, skits and speeches by [End Page 462] stars of Broadway and Hollywood, which played to capacity crowds at Madison Square Garden in 1941. When reports of the mass murder of Europe's Jews were confirmed in late 1942, Hecht joined the Bergson Group, a political action committee that sought to pressure the Roosevelt administration to aid Jewish refugees. Toward that end, he authored another dramatic spectacle at Madison Square Garden, We Will Never Die. The defiant title summed up Hecht's credo. Gorbach recounts Hecht's unsuccessful effort to coax a sympathetic message from the White House to read aloud at the event. The president and his aides feared that calling attention to the slaughter would increase the pressure to open America's doors. For Hecht, that episode was a bitter reminder that before rescuing Jews, he and his comrades first had to "rescue the word 'Jew' from the garbage can" (181). In their public statements about Nazi oppression in 1942–1943, President Roosevelt and other US officials mentioned refugees of various nationalities—but not Jews. Even a White House statement marking the first anniversary of the Warsaw Ghetto revolt failed to acknowledge that the fighters were Jews. Whether to focus on Jews or subsume their suffering among that of other oppressed peoples is a debate that did not end with World War II. Hecht addressed the problem the way he knew best—with his pen. In full-page advertisements with headlines such as "Time Races Death" and "They...

Solidarity in genomic healthcare? Results of the Belgian citizen forum (2018)

Abstract Genomic medicine requires to collect and use a huge amount of patient and citizen data. Therefore, the Belgian Minister of Public Health decided to organize a citizen forum on the ethical, legal and societal issues (ELSI) surrounding the use of genomic information in healthcare. This initiative follows the trend of public involvement in Europe regarding ELSI in genomics. During three weekends, a panel of 32 citizens, informed by experts of different backgrounds, produced political recommendations. We will focus on their conception of solidarity, which is crucial to take into account when considering policies on data sharing in genomics. Citizens of the panel consider their genome simultaneously as the individual’s property and as something to be shared for the common good. As a consequence, the panel agrees to support solidarity provided individual interests, such as privacy protection, are respected. By solidarity, the panel means supporting genomic data sharing for the common good, which they define as scientific research that improves knowledge (on both prevention and diagnostics) to build a fair society where everyone has an equal opportunity to live healthy. According to the panel, the government should actively encourage citizens to share their genomic data, but no one can be forced to do it. For instance, the government could motivate citizens to share their genomic data by partially reimbursing genomic tests undertaken without medical prescription. However, because everyone has an equal right to live healthy, the panel esteems that genomic tests for medical needs should be accessible for all, thanks to a well-thought-out and sustainable refund system. Key messages Citizens support solidarity in genomic medicine, but demand proportional individual protection. As citizens become increasingly important stakeholders in genomic medicine, all public authorities should actively engage citizens in relevant healthcare policies.

SUN-326 CLINICAL MANIFESTATIONS AND LONG-TERM OUTCOMES OF IGG4-RELATED KIDNEY AND RETROPERITONEAL INVOLVEMENT IN A UNITED KINGDOM IGG4-RELATED DISEASE COHORT

IgG4-related disease (IgG4-RD) is a relapsing multisystem fibro-inflammatory disease, which may involve the kidney (IgG4-related kidney disease; IgG4-RKD) and retroperitoneum (IgG4-related retroperitoneal fibrosis; IgG4-RPF). Cohorts of patients with IgG4-RKD and IgG4-RPF have been reported in North America and Asia, but the features of renal involvement in Europe are yet to be described. We undertook this study to describe the clinical characteristics and outcomes of renal and retroperitoneal involvement in a cohort of IgG4-RD patients from the United Kingdom (UK).

The Anglo-French defence partnership after the “Brexit” vote: new incentives and new dilemmas

Since the signing of the Lancaster House Treaties in 2010, the bilateral partnership between Paris and London has been a key axis for both countries’ involvement in Europe’s security and defence affairs. What impact can the result of the “Brexit” vote have on this rising partnership? This contribution argues that while the partnership will undoubtedly remain central in Europe, the two parties will in the future both face contradictory incentives. While London will have new incentives to invest in its relationship with Paris, it might also try to discourage further defence integration in the EU. On the contrary, France – which had been more forward leaning, and concerned with Britain’s lack of commitment to a bilateral relationship they considered central – will be tempted to look elsewhere. Indeed, the ambition for a militarily active European Union with a strong defence industrial base may prove contradictory with an investment in the bilateral partnership with London.

European Integration and the End of an Imperial Consciousness in Britain

This article examines the impact of European integration between 1961 and 1975 on national and imperial consciousness in Britain. It suggests that the end of imperial sentiment that was brought about by greater involvement in Europe did not produce a strong or deep attachment to the idea of European integration. Arguments about the need for European integration to transcend war in Europe tended to reinforce a sense of Commonwealth commonality for the British rather than a sense of European commonality. Although the Empire and Commonwealth had become a mere source of nostalgia in British consciousness by 1975, the weak support for European integration continues to condition British attitudes to European integration to this day. Indeed, in the current Eurosceptic climate, the Dominions are making a return to British political consciousness.

Relationship Between Motorcyclists’ Attitudes, Behavior, and Other Attributes With Declared Accident Involvement in Europe

Objective: The objective of this study is to investigate patterns of road safety attitudes and behaviors of motorcyclists in Europe on the basis of the results of the pan-European questionnaire-based survey SARTRE-4, carried out in late 2010 in 18 European countries and Israel. In addition, we attempt to explore the link between attitudes, behaviors, and other motorcyclist attributes with motorcyclist involvement in accidents in the past 3 years, in which someone, including the rider, was injured and received medical attention as stated in the motorcyclists’ responses. Methods: The various components of motorcyclist attitudes and behaviors such as reasons for driving a motorcycle, driving while impaired, perceived risk factors, and risk-taking behavior were determined by means of a principal component analysis (PCA) on 38 variables contained in the survey. A binary logistic regression model was then applied in order to link the attitudes and the stated behavior with the declared involvement in past accidents. Results: The results revealed 8 components. Component 1 (driving while impaired and speeding accident factors), component 2 (motorcycle benefits), component 3 (perceived risk of maneuvers), component 4 (sensation seeking), component 5 (road, vehicle, and environmental risk factors), component 7 (no modal options), and component 8 (attitudes toward drinking and friends’ drinking) are associated with stated preferences and attitudes, whereas component 6 (dangerous and angry behaviors) is associated with stated behavior. Moreover, it was found that motorcyclists who tend to have dangerous attitudes and behaviors as well as younger motorcyclists are more likely to have been involved in an accident. It was also showed that driving exposure is positively associated with increased probability of a past accident. Conclusions: The findings of the study provide some insight into the association between attitudes, behaviors, and declared past accident involvement. Furthermore, the analysis of such large databases with the inclusion of many different countries constitutes a step for further research in the field of motorcyclists’ behaviors and safety. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Germany vs. Europe: The Principle of Democracy in German Constitutional Law and the Struggle for European Integration

As the Euro-crisis grinds on, the German Federal Constitutional Court has repeatedly intervened to review and qualify Germany’s essential participation in bail-out measures. The Court has sought to ensure that involvement in Europe’s ever-deeper economic and political integration does not compromise Germany’s domestic constitutional commitment to democracy. The principle of democracy (Demokratieprinzip) is part of Germany’s unalterable “constitutional identity” and it has emerged as the main limitation on Germany’s participation in and contribution to the European Union. On the basis of the German Constitutional Court’s European jurisprudence, this paper characterizes the principle of democracy as a valorization of fully-informed, rational, parliamentary governance exercised on behalf of the electorate by a plurality of widely representative political parties in open debate over public policy. This is a vision of democracy suited to national political systems and cultures and only poorly aligned with the reality of Europe’s supranational political institutions and framework.

The Europeanization of France's foreign policy towards the Middle East conflict – from leadership to EU-accommodation

France's prominent role in Europe's policy towards the Arab-Israeli conflict represents an interesting case study for the evolving research on Europeanization. While France's involvement in the CFSP is frequently described as a case of national projection through the EU, this view needs qualification. Proposing a novel conceptual categorization of different member state approaches to European foreign policy cooperation, this article shows that France's involvement in Europe's Middle East policy has gone through different phases. Guided by de Gaulle's politique arabe, France assumed a ‘leadership’ role in Europe's common foreign policy, leaving a strong mark on its collective diplomacy. Since the 1990s, however, a number of complementary changes have weakened France's capacity for leadership, challenging well-established French foreign policy positions. France's response to the mounting constraints of EU-level cooperation has oscillated between ‘re-nationalization’ and efforts to ‘facilitate’ a common European approach, displaying a considerable degree of pragmatism and tactical adaptation.

Mobility and social capital among Lebanese and Beninese entrepreneurs engaged in transnational trade

This contribution focuses on importers of second-hand cars operating between Brussels, Belgium and Cotonou, Benin. Intensive multi-sited field-work reveals important differences in the way Lebanese and Beninese car importers operate in this import–export business and how they circulate between Europe and West Africa. This paper, through a comparative approach, describes and explains those differences. A first level of explanation is linked to the fact that car importers working in Cotonou come primarily from two different communities. On the one hand, Lebanese car importers operate inside a trade diaspora, never needing to travel because they are able to rely on other Lebanese to send them second-hand cars from Brussels and to collaborate at different levels of the trade chain. On the other hand, native Beninese car importers have the status of cross-border entrepreneurs working in a territory of movement. They must themselves travel to Europe to obtain their second-hand cars, thereby maintaining a double involvement in Europe and West Africa. A second level of explanation can be found in the evolution of the Euro-African second-hard car import–export business, a trade pioneered by Lebanese entrepreneurs. What began as a fragmented activity became formalised in business hubs, such as Brussels. This centralisation allowed the arrival of new types of car importers, like the Beninese, on the market. However, unlike the Lebanese, these newcomers could not rely on settlements of fellow-countrymen located in multiple business markets and had low levels of trust between each other. To this day, they have failed to mobilise the capital necessary to work in the same conditions as the Lebanese. What distinguishes Lebanese and Beninese second-hand car importers? The analysis shows that it is their ability to recreate trust in a context of high uncertainty. This issue of trust has a direct impact on the way both types of importers organise their spatial mobility and operate their business activities.

Scale economies in hedging foreign exchange cash flow exposures

This study finds that a sample of U.S.-based multinational corporations (MNCs) with heavy involvement in Europe is less frequently exposed to European currency risk than to non-European currency risk. Furthermore, 60% of the time, the MNCs without European exposure are found to have non-European exposure. These results are likely due to scale economies in foreign exchange exposure hedging that recently has been suggested in the literature. To the extent that economies of scale in hedging exist, it is likely that MNCs can achieve these economies in areas where they conduct substantial business activities, thus are more able to justify the necessary hedging programs.

The lost origins of Ireland’s involvement in Europe: the Irish response to the Briand Plan, 1929–30

In a collected volume assessing Ireland’s involvement in European integration Gearóid Mac Niocaill and Gearóid Ó Tuathaigh wrote that With the establishment of an Irish National State in 1922 the opportunities for expanding Irish links with Europe seemed greatly enhanced. It remained to be seen if these opportunities would be taken.However, Patrick Keatinge reminded readers of the same volume that ‘Up to the late 1950s Ireland’s diplomatic persona was only slightly “European”.’ Most Irish diplomatic historians would agree with this interpretation, arguing that Britain, the Commonwealth and the League of Nations remained the primary focus of Irish foreign policy in the inter-war period. Supporting Keatinge’s interpretation, the existing historical literature suggests that Irish diplomats were rather slow in renewing the perceived longstanding contacts with continental Europe before the Second World War. Indeed, Roy Foster has criticised the discursive claim of Ireland’s longstanding contacts with continental Europe, made by many Irish policy-makers at the time of Ireland’s entry into the European Economic Community in 1973, as a ‘grandiose self-delusion’. Most historical accounts, therefore, suggest that Ireland’s involvement in Europe tentatively started with the involvement in the Marshall Plan and participation in the Council of Europe.

Biofeedback

Biofeedback (BFB) is thirty years old, but most professionals in Europe (psychologists, medical doctors, and university teachers) are not familiar with it; and those who do claim to know it have a stereotypical idea of what it represents, considering it an alternative therapy like meditation, ayurveda, yoga, or herbal preparations for generic relaxation and for certain types of functional (presumed relaxation-dependent) pathology. Despite this superficial understanding, over the years, thanks to unheralded but reliable work, performed mostly in the United States, but with involvement in Europe that is growing in quality and in quantity, BFB has been realizing a twofold increase in knowledge: