Rates In European Countries Research Articles

The effects of negative interest rates on cash usage: Evidence for EU countries

Changes in interest rates below the zero lower bound could have potential effects on the payments market by making cash more attractive for consumers as a medium of payment and wealth storage. This paper studies how cash usage has been affected by the recent introduction of negative interest rates in European countries. Using a difference-in-differences methodology over the period 2006–2018, results show an increase in cash usage in negative interest-rate environments. We also find that the increase in cash usage was less pronounced in countries with superior monitoring capacity of banks (i.e. high levels of financial intermediation).

Self-Reported Lower Gastrointestinal Endoscopy Use and Changes in Colorectal Cancer Mortality Rates in European Countries.

INTRODUCTION:To quantify the association of self-reported lower gastrointestinal endoscopy use measured in 2004/05 with colorectal cancer (CRC) mortality changes over 2004–2015 in Europe.METHODS:An ecological analysis was performed using endoscopy utilization data from the Survey of Health, Aging, and Retirement in 11 European countries in 2004/05 and CRC mortality data from the World Health Organization Mortality Database over 2004–2015. Mortality trends were compared through annual mortality changes from joinpoint regression models. Cross-national variations in mortality trends with respect to endoscopy use were tested for statistical significance by negative binomial regression models.RESULTS:The proportion of respondents who reported having had an endoscopy within 10 years varied widely across countries, from 6.1% to 25.1%. Large disparities in CRC mortality trends were also observed, with annual mortality change ranging from a decline of 3.3% to an increase of 0.9% for men and from a decline of 3.3% to a decline of 0.6% for women. Endoscopy uptake was negatively associated with the magnitude of annual mortality change over 2004–2015 (rate ratio for a 10-year mortality change per 10% higher endoscopy use, 0.88; 95% confidence interval, 0.82–0.94).DISCUSSION:This analysis provides quantitative evidence on the contributions of endoscopy use to CRC mortality declines in European countries over the past decade. A considerable fraction of protection is likely to be delivered through endoscopic removal of adenomas and sessile serrated lesions. With many European countries having recently implemented CRC screening programs, an increase in endoscopy use and a subsequent reduction in CRC mortality would be expected.

Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19.

Large differences in COVID‐19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS‐CoV‐2 binds to its receptor, the angiotensin‐converting enzyme 2 (ACE2). As a result of SARS‐CoV‐2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT1R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID‐19. The nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT1R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof‐of‐concept of dietary manipulations that may enhance Nrf2‐associated antioxidant effects, helpful in mitigating COVID‐19 severity.

Increase in COVID-19 cases and case-fatality and case-recovery rates in Europe: A cross-temporal meta-analysis.

The new coronavirus (COVID‐19) infection reported in China in December 2019 has become a pandemic in a few weeks, affecting the entire world. In this respect, it is crucial to determine the case‐increase, case‐fatality, and case‐recovery rates to control COVID‐19. In this study, the case‐increase, case‐fatality, and case‐recovery rates of COVID‐19 in 36 European countries were analyzed with the meta‐analysis method using data released by the health organizations and WHO. The data were obtained from the website of health organizations of 36 European countries and the website of WHO until 11 May 2020. The analyses were carried out on 1 744 704 COVID‐19‐diagnosed cases in 36 European countries. The case‐increase, case‐fatality and case‐recovery rates of COVID‐19 were calculated using 95% confidence intervals (95% CI), single‐arm meta‐analysis, cross‐temporal meta‐analysis, and meta‐regression random‐effects model. The standardized case‐increase rate of COVID‐19 is 5% (95% CI [0.040, 0.063]) and the average case‐increase rate in European countries has started to decline by around 3% (95% CI [0.047, 0.083]) weekly. The countries with the highest rate of case increase are Belgium, Sweden, Russia, the Netherlands and the United Kingdom. Although the case‐fatality rate of COVID‐19 patients was 4.5% as of May 11 (95% CI [0.037‐0.055]), this rate is 6.3% (95% CI [0.047, 0.083]) in standardized time (6th week). The case‐recovery rates of patients are 46% (95% CI [0.376‐0.547]). This study presents important results regarding the COVID‐19 pandemic in Europe. Although the rate of increase in new COVID‐19 cases has dropped, there is not much decline in the case‐fatality rates and no increase in case‐recovery rates. The case‐fatality rate of COVID‐19 in Europe was estimated to be in the range of 4% to 4.5% and a minimum of 4 weeks (as of 11 May) is expected to have the figure below 1% in a country with an average case‐increase rate. Monitoring case fatalities in Belgium, the Netherlands and Sweden, and treatment successes in Germany and Austria play a role of utmost importance.

Ecologic association between influenza and COVID-19 mortality rates in European countries.

Ecologic studies investigating COVID-19 mortality determinants, used to make predictions and design public health control measures, generally focused on population-based variable counterparts of individual-based risk factors. Influenza is not causally associated with COVID-19, but shares population-based determinants, such as similar incidence/mortality trends, transmission patterns, efficacy of non-pharmaceutical interventions, comorbidities and underdiagnosis. We investigated the ecologic association between influenza mortality rates and COVID-19 mortality rates in the European context. We considered the 3-year average influenza (2014-2016) and COVID-19 (31 May 2020) crude mortality rates in 34 countries using EUROSTAT and ECDC databases and performed correlation and regression analyses. The two variables - log transformed, showed significant Spearman's correlation ρ = 0.439 (P = 0.01), and regression coefficients, b = 0.743 (95% confidence interval, 0.272-1.214; R2 = 0.244; P = 0.003), b = 0.472 (95% confidence interval, 0.067-0.878; R2 = 0.549; P = 0.02), unadjusted and adjusted for confounders (population size and cardiovascular disease mortality), respectively. Common significant determinants of both COVID-19 and influenza mortality rates were life expectancy, influenza vaccination in the elderly (direct associations), number of hospital beds per population unit and crude cardiovascular disease mortality rate (inverse associations). This analysis suggests that influenza mortality rates were independently associated with COVID-19 mortality rates in Europe, with implications for public health preparedness, and implies preliminary undetected SARS-CoV-2 spread in Europe.

Austerity Policies and Mortality Rates in European Countries, 2011-2015.

To assess time trends in mortality rates in European countries for the period 2011 to 2015 by level of austerity measures imposed by governments in response to the economic and financial crisis. We analyzed standardized mortality rates (SMRs) for 2011 through 2015 in 15 European countries based on Eurostat data ( http://ec.europa.eu/eurostat/data/database ). We used the Cyclically Adjusted Primary Balance (CAPB) in terciles as an independent variable to represent the level of austerity adopted in each country. We conducted a longitudinal analysis of panel data using generalized estimating equation models of SMR. We included interaction terms to assess the influence of time period and level of austerity. SMRs generally declined in the study period, except in the last year of the study. In 2015, compared with countries in the low-austerity group, countries with intermediate austerity had excess mortality of 40.2 per 100 000 per year and those with high austerity had excess mortality of 31.22 per 100 000 per year. The results suggest a negative effect on mortality in those countries that apply a higher level of austerity.

Foreign-Born Adults’ Participation in Educational Activities: Evidence From Europe

This article demonstrates that foreign-born adults in Europe tend to participate less in adult education activities compared to native-born adults living in the same country. However, this is mainly explained through the job-related nature of nonformal education. Foreign-born adults tend to participate more in formal adult education than native-born adults in a range of countries. Based on analyses using data from the Organization for Economic Cooperation and Development Programme on the International Assessment of Adult Competencies (PIAAC), this article shows that participation rates in European countries are mainly determined by adults’ educational attainment and having a job and that countries with overall high participation rates have higher participation rates among foreign-born adults as well. Exploring the participation in adult education of foreign-born adults in European countries is important, as it is known that those adults perceive difficulties in finding a job and having their foreign credentials recognized in the new country context. Participation in adult education courses might help them in learning new or maintaining their already existing skills.

The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): first EUROMACS Paediatric (Paedi-EUROMACS) report

EUROMACS is a registry of the European Association for Cardio-Thoracic Surgery (EACTS) whose purpose is to gather clinical data related to durable mechanical circulatory support for scientific purposes and to publish annual reports. Because the treatment of children with end-stage heart failure has several significantly different characteristics than the treatment of adults, data and outcomes of interventions are analysed in this dedicated paediatric report. Participating hospitals contributed pre-, peri- and long-term postoperative data on mechanical circulatory support implants to the registry. Data for all implants in paediatric patients (≤19 years of age) performed from 1 January 2000 to 31 December 2017 were analysed. This report includes updates of patient characteristics, implant frequency, outcome (including mortality rates, transplants and recovery rates) as well as adverse events. Twenty-five hospitals contributed 237 registered implants in 210 patients (81 ♀, 129 ♂) to the registry. The most frequent diagnosis was any form of cardiomyopathy (71.4%) followed by congenital heart disease (18.6%). Overall mean support time on a device was 11.6 months (±16.5 standard deviation). A total of 173 children (82.4%) survived to transplant, recovery or are ongoing; 37 patients (17.6%) died while on support within the observed follow-up time. At 12 months 38% of patients received transplants, 7% were weaned from their device and 15% died. At 24 months, 51% of patients received transplants, 17% died while on support, 22% were on a device and 9% were explanted due to myocardial recovery. The adverse events rate per 100 patient-months was 11.97 for device malfunction, 2.83 for major bleeding, 2.83 for major infection and 1.52 for neurological events within the first 3 months after implantation. The first paediatric EUROMACS report reveals a low transplant rate in European countries within the first 2 years of implantation compared to US data. The 1-year survival rate seems to be satisfactory. Device malfunction including pump chamber changes due to thrombosis was the most frequent adverse event.

Availability and use of mental health services in European countries: Influence on national suicide rates

BackgroundPrevious research suggests significant increases in suicide mortality rates in European countries following the economic crisis of 2008. However, the relationship between national differences in availability and use of mental health services and suicide rates has not been extensively examined yet. Materials and methodsData on mental health services and socioeconomic variables were derived from Eurostat for the years 2000–2013 for ten European countries. The national health care variables consisted of suicide mortality rate (SMR), average length of hospital stay and number of hospitalizations due to affective disorder or any psychiatric disorder, number of psychiatric beds and number of prescribed antidepressants. Economic variables included the gross domestic product (GDP), the gross domestic product per 1000 inhabitants (Real GDP), the rate of unemployment and the GINI-coefficient as a measurement for the equality of wealth distribution. Mixed models were used to investigate the potential influence of the onset of the economic crisis in 2008 on each of the psychiatric variables. Multivariable regression analyses were used to assess the influence on suicide mortality rates. ResultsIn this study, a significant change in slope starting from 2008 was revealed for the number of psychiatric beds, hospitalizations due to affective disorder or any psychiatric disorder and for prescribed antidepressants. Furthermore, a significant step change for hospitalizations due to affective disorder was observed in 2008. SMR exhibited a significant step change in 2008 for males and females as well as a significant change in slope from 2008 onwards for males only. Contrary to our hypothesis, most variables showed no statistically significant influence on SMR. Only a higher number of available psychiatric beds was significantly associated with higher suicide mortality rates. This effect, however, was only significant for females and did not remain significant after correcting for economic variables. Less than 10% of suicide mortality rate variability could be explained by a model including all variables, further corroborating the multifactorial etiology of suicide. LimitationsSince administrative registry data was used, the results should be interpreted with caution. Results might not be applicable to countries not included. ConclusionWhile significant changes in the psychiatric variables, as well as SMR, were observed, no statistically significant influence on SMR remained after correcting for country, time and economic variables. Our study suggests the necessity of a more comprehensive international data gathering effort. Further research is needed to identify populations at risk of suicide.

Suicide rates in the European Union Countries. An analysis from a multivariate approach

Suicide is one of the most important causes of death in the European Union Countries (EU) and is considered as a phenomenon which can be explained from a psychological, biological and social point of view. Objectives: This research will analyze the phenomenon of suicide in the European Union from a sociological point of view, with the aim of creating a multivariate model which explains such phenomenon. Method: Taking into account those data offered by the European Statistics Office (EUROSTAT), this study will try to explain, through the multiple linear regression model, suicide rates in European countries from demographic variables (number of inhabitants, divorce rate, ratio of women), economic variables (Gross Domestic Product (GDP), general government gross debt), social variables (government expenditure on social protection, population at risk of poverty) or educational variables (public expenditure on education and population with secondary education). Conclusions: A model to explain suicide rates in different countries was developed. This model was made up of two variables (percentage of people with secondary education and ratio of women), which account for 50% of the suicide rate.

Targeting mesothelin receptors with drug-loaded bacterial nanocells suppresses human mesothelioma tumour growth in mouse xenograft models.

Human malignant mesothelioma is a chemoresistant tumour that develops from mesothelial cells, commonly associated with asbestos exposure. Malignant mesothelioma incidence rates in European countries are still rising and Australia has one of the highest burdens of malignant mesothelioma on a population basis in the world. Therapy using systemic delivery of free cytotoxic agents is associated with many undesirable side effects due to non-selectivity, and is thus dose-limited which limits its therapeutic potential. Therefore, increasing the selectivity of anti-cancer agents has the potential to dramatically enhance drug efficacy and reduce toxicity. EnGeneIC Dream Vectors (EDV) are antibody-targeted nanocells which can be loaded with cytotoxic drugs and delivered to specific cancer cells via bispecific antibodies (BsAbs) which target the EDV and a cancer cell-specific receptor, simultaneously. BsAbs were designed to target doxorubicin-loaded EDVs to cancer cells via cell surface mesothelin (MSLN). Flow cytometry was used to investigate cell binding and induction of apoptosis, and confocal microscopy to visualize internalization. Mouse xenograft models were used to assess anti-tumour effects in vivo, followed by immunohistochemistry for ex vivo evaluation of proliferation and necrosis. BsAb-targeted, doxorubicin-loaded EDVs were able to bind to and internalize within mesothelioma cells in vitro via MSLN receptors and induce apoptosis. In mice xenografts, the BsAb-targeted, doxorubicin-loaded EDVs suppressed the tumour growth and also decreased cell proliferation. Thus, the use of MSLN-specific antibodies to deliver encapsulated doxorubicin can provide a novel and alternative modality for treatment of mesothelioma.

Safety of catheter ablation of atrial fibrillation using fiber optic–based contact force sensing

While the body of evidence showing the benefit of contact force (CF)-sensing catheters in improving atrial fibrillation ablation success rate is growing, real-world safety data of this technology are limited. The aim of this study was to report the complication rate in patients undergoing ablation using a specific CF-sensing catheter (TactiCath Quartz CF ablation catheter, Abbott, St. Paul, MN) in a large worldwide database. User-reported adverse event data from January 1, 2014 to December 31, 2015 were reviewed for the ablation catheter. These adverse events included cardiac perforation, cerebrovascular accident, atrioesophageal (AE) fistula, steam pop, and death. Rates of these adverse events, including geographic and temporal relationships, were calculated. Adverse events were reported in 178 of 41,709 patients (adverse event rate 0.427%). Adverse events included 117 cardiac perforations (0.281%), 5 cerebrovascular accidents (0.012%), 10 AE fistulas (0.024%), 53 audible steam pops (0.127%), and 13 deaths (0.031%). The total event rate in European countries was 0.53% vs 0.38% in the United States (P = .0082). The AE fistula event rate peaked in late 2014 and early 2015 at 0.06% and decreased over time to a steady-state 0.01%, corresponding to the initial US release, subsequent increased use, and training on the manufacturer recommended settings. Complication rates while using the TactiCath CF ablation catheter appear to decrease with training and experience. The major complication rate associated with this technology is low in the context of similar reports of conventional radiofrequency catheters.

Optimization of family planning service in Ukraine in the realization of modern strategy of woman health maintenance

The primary objective of the reproductive health services system and its individual institutions are, namely: to implement the strategy of women management starting from their fetal life to the old age and ensure quality of life in adolescence, reproductive and postmenopausal periods. Maternal and child death rates are above respectives rates in European countries, and utilization rate of modern contraceptive methods in Ukraine remains low. This can be explained by both, poor awareness of women and insufficient training of medical personnel. In this context, the top priority still is awareness-raising and further implementation of the strategy on reliable contraception means and methods along with effective preconception care as a potent component of family planning.Taking into account modern global trends, the principal goal of Family Planning Service in Ukraine is to improve women’s quality of life and time of active ageing, which achievement can be facilitated by the implementation of 3 priority tasks:• continued realization of the strategy on reliable contraception use and implementation of effective preconception care to abortions prevention and maternal and newborns mortality rates reduction;• reduction cardiovascular and oncological diseases incidence rate in women through development and implementation of respective screening programs, informational and preventive measures;• implementation of best international practices with respect to Family Planning Service efficacy, review and update of family planning clinical protocol with further implementation of such practices at the national and regional levels.Considering this, the Resolution of Advisory Board outlines the main tasks for the implementation of modern international experience and its further implementation at the national level, and amendments to clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care (approved by the order of MOH of Ukraine No. 59 dated January 21, 2014) “Family Planning”. The main additions and comments touched upon the issues of micronutrient status and reproductive health of women, contraceptive methods for women in perimenopause, counseling and selection of contraceptive methods for HIV-positive women. Particular attention was paid to counseling and selection of contraceptive methods for women military personnel.

The Rise in Divorce and Cohabitation: Is There a Link?

Over the past decades, divorce and cohabitation have increased dramatically throughout Europe. Divorce has fundamentally altered the institution of marriage from a life-long union to one that may dissolve. Cohabitation allows couples to live together without undertaking the vows of marriage, but also allows couples to avoid the potentially higher costs of divorce. Thus, divorce and cohabitation seem to be intrinsically linked. Here we theorize how the increase in divorce may be linked to the increase in cohabitation on the macro-, meso-, and micro- levels. Using focus group data from 8 countries, we explore how divorce may have changed attitudes and beliefs concerning marriage and cohabitation. We then investigate whether survey data and official statistics in 16 countries provide evidence consistent with a link. While exogenous factors have been important for the increase in cohabitation, we argue that the divorce revolution has been a catalyst for the cohabitation boom.

Socioeconomic inequalities in stillbirth rates in Europe: measuring the gap using routine data from the Euro-Peristat Project.

BackgroundPrevious studies have shown that socioeconomic position is inversely associated with stillbirth risk, but the impact on national rates in Europe is not known. We aimed to assess the magnitude of social inequalities in stillbirth rates in European countries using indicators generated from routine monitoring systems.MethodsAggregated data on the number of stillbirths and live births for the year 2010 were collected for three socioeconomic indicators (mothers’ educational level, mothers’ and fathers’ occupational group) from 29 European countries participating in the Euro-Peristat project. Educational categories were coded using the International Standard Classification of Education (ISCED) and analysed as: primary/lower secondary, upper secondary and postsecondary. Parents’ occupations were grouped using International Standard Classification of Occupations (ISCO-08) major groups and then coded into 4 categories: No occupation or student, Skilled/ unskilled workers, Technicians/clerical/service occupations and Managers/professionals. We calculated risk ratios (RR) for stillbirth by each occupational group as well as the percentage population attributable risks using the most advantaged category as the reference (post-secondary education and professional/managerial occupations).ResultsData on stillbirth rates by mothers’ education were available in 19 countries and by mothers’ and fathers’ occupations in 13 countries. In countries with these data, the median RR of stillbirth for women with primary and lower secondary education compared to women with postsecondary education was 1.9 (interquartile range (IQR): 1.5 to 2.4) and 1.4 (IQR: 1.2 to 1.6), respectively. For mothers’ occupations, the median RR comparing outcomes among manual workers with managers and professionals was 1.6 (IQR: 1.0–2.1) whereas for fathers’ occupations, the median RR was 1.4 (IQR: 1.2–1.8). When applied to the entire set of countries with data about mothers’ education, 1606 out of 6337 stillbirths (25 %) would not have occurred if stillbirth rates for all women were the same as for women with post-secondary education in their country.ConclusionsData on stillbirths and socioeconomic status from routine systems showed widespread and consistent socioeconomic inequalities in stillbirth rates in Europe. Further research is needed to better understand differences between countries in the magnitude of the socioeconomic gradient.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0804-4) contains supplementary material, which is available to authorized users.

Explaining labor wedge trends: An equilibrium search approach

(ProQuest: ... denotes formulae omitted.)1. IntroductionOver the last few decades, most OECD countries have shown large differences in aggregate hours of market work. The interesting issue of understanding these differences in work effort has resulted in a number of significant contributions. For instance, Prescott (2004) studies the taxes account for differences in labor supply over time and across countries from the early 1970's to the mid-1990's and finds that for acceptable values of labor supply elasticity, the effective marginal tax rate on labor income explains most of the differences at points of time and the large change in relative (to US) labor supply over time. On this line of research, Rogerson (2004) points to the role of taxes and technology as determining factors in the changes from 1956-2000, whereas Rogerson (2006) argues that changes in technology and government are promising candidates to explain the broad changes over the period 1956-2003. Finally, Ohanian, Raffo and Rogerson (2008) emphasize the intensive margin of aggregate hours of work and find that the neoclassical growth model, augmented with taxes, can account for most of the variations over the period 1956-2004.However, since the late 1970's, the differences in aggregate hours across countries seem to be largely to quantitatively important differences along the extensive margin. Moreover, the relative change in the employment rate behaves differently than the relative change in hours worked per employee. To stress this point, Langot and Quintero Rojas (2009) construct counterfactuals to quantify the relative importance of the extensive and intensive margins of aggregate hours of market work in the observed differences between Europeans and Americans since the 1970's. They show that the extensive margin explains most of the total-hoursgap between regions, while the intensive margin plays the smallest role. Furthermore, Ljungqvist and Sargent (2007a, 2007b and 2008) suggest that the large decrease in the employment rate in European countries observed after 1980, was an important factor in the dynamics of total hours worked. In addition, there is a bulk of evidence from previous literature on the European unemployment problem regarding the effects of labor market indicators other than taxes on the extensive margin4.This suggests that the basic neo-classical growth model with endogenous labor supply is insufficient to account for the impact of the various labor market institutions on aggregate hours of work. However, when this model is extended to include a search and matching process in the labor market it is able to explain the employment dynamics. An example of this is the study by Quintero Rojas (2009), who examines the incidence of various labor market institutions on the extensive margin to explain the evolution of aggregate hours over the period 1980-2003. However, her model holds the intensive margin constant, thereby neglecting an interesting dimension of the problem.Against this rich background, our main contribution is twofold. Firstly, we take into account the differentiated dynamics of the two main margins of aggregate hours of work, i.e., the average hours worked per employee (or intensive margin); and the employment rate (or extensive margin). This enables us to assess the relative effect of taxes on each margin, on the one hand; and that of unemployment benefits and workers' bargaining power on the other. Secondly, the analysis covers the updated period 1980-2013.More precisely, we develop a dynamic general equilibrium model with search and matching frictions, wage bargaining, and efficient bargain on the number of hours worked per employee. The model is extended to include a tax/benefit system consisting of taxes on consumption, labor income, and payroll, unemployment benefits, and the workers' wage bargaining power. Since the model distinguishes between the two margins of the aggregate hours of work, we are able to look at the relative contribution of taxes and labor market institutions to each margin. …

Stock markets and effective exchange rates in European countries: threshold cointegration findings

The nexus between stock markets and exchange rates is examined in the case of eight European countries. The sample consists of four economies with national currencies and four that have adopted the euro. Thus, if differences between the two groups in the relationship governing the two markets exist, they will be unveiled. To this effect, a threshold cointegration methodology is adopted that allows for more reliable inferences to be drawn for both the short and long run nexus between the two markets. Monthly data is used covering the period 01/2000–12/2014. The findings reported herein offer support in favor of the portfolio approach thesis over the recent economic crisis period, but this finding is not the case for the entire sample. Bidirectional causality is found for Norway and the UK, pointing to a currency effect on stock markets. In view of the findings reported herein, policies aiming at reducing uncertainty in the stock markets can exert beneficial effects on currency markets.

What contributes to disparities in the preterm birth rate in European countries?

Purpose of reviewIn countries with comparable levels of development and healthcare systems, preterm birth rates vary markedly – a range from 5 to 10% among live births in Europe. This review seeks to identify the most likely sources of heterogeneity in preterm birth rates, which could explain differences between European countries.Recent findingsMultiple risk factors impact on preterm birth. Recent studies reported on measurement issues, population characteristics, reproductive health policies as well as medical practices, including those related to subfertility treatments and indicated deliveries, which affect preterm birth rates and trends in high-income countries. We showed wide variation in population characteristics, including multiple pregnancies, maternal age, BMI, smoking, and percentage of migrants in European countries.SummaryMany potentially modifiable population factors (BMI, smoking, and environmental exposures) as well as health system factors (practices related to indicated preterm deliveries) play a role in determining preterm birth risk. More knowledge about how these factors contribute to low and stable preterm birth rates in some countries is needed for shaping future policy. It is also important to clarify the potential contribution of artifactual differences owing to measurement.

Regional Variations in ECT Use in Europe

Large variations in worldwide ECT utilization have been described (Leiknes et al. 2012) and concerns have been raised that ECT is being underused in some countries (with some patients being deprived of the most effective treatments available) While overused in certain locations (Smith et al. 1985). To describe ECT utilization rates in European countries and to examine barriers difficulting its accesibility to ECT in Europe A systematic review was conducted of studies which reported on ECT utilization rates in european countries in the last 25 years Wide variations in the use of ECT have also been reported among neighbouring countries and even among different regions within the same country. Lack of human and material resources, economic and legal restrictions, lack of agreement between psychiatrists and social prejudices against ECT might be behind these variations. Action is needed that ensures a more uniform access to ECT. Health education campaigns, clinical practice guidelines development and implementation and ECT training courses promotion could contribute toward this.

Regional Variations in the Use of ECT in Europe

Introduction Large variations in worldwide ECT utilization have been described (Leiknes et al. 2012) and concerns have been raised that ECT is being underused in some countries (with some patients being deprived of the most effective treatments available) While overused in certain locations (Smith et al. 1985). Objectives and aims To describe ECT utilization rates in European countries and to examine barriers difficulting its accesibility to ECT in Europe Methods A systematic review was conducted of studies which reported on ECT utilization rates in european countries in the last 25 years Results Wide variations in the use of ECT have also been reported among neighbouring countries and even among different regions within the same country. For example, marked differences have been reported among baltic or nordic countries. In Norway, ECT utilization rate ranged from 1,83 to 3,44 treated per 10.000 inhabitants-year, in Belgium from in Flanders to 10,6 in Brussels and in Edinburgh 18-fold differences have been reported among different psychiatric teams within the same hospital. Lack of human and material resources, economic and legal restrictions, lack of agreement between psychiatrists and social prejudices against ECT might be behind these variations. Conclusions Action is needed that ensures a more uniform access to ECT. Health education campaigns, clinical practice guidelines development and implementation and ECT training courses promotion could contribute toward this.