Survey In Europe Research Articles

Autoinjector preference in multiple sclerosis and the role of nurses in treatment decisions: results from an international survey in Europe and the USA.

PurposeThis international survey recorded the opinions of multiple sclerosis (MS) nurses about their role in treatment decision making and about the importance of different attributes of autoinjectors used to deliver first-line parenteral therapy.MethodsThe survey involved 52 MS nurses in different practice settings in France, Germany, Italy, the UK, and the USA. Nurses described their role in patient education and in treatment decision making. They also rated the importance of nine prespecified attributes of autoinjectors and stated their preference, both overall and by attribute, for one of two autoinjectors used to deliver interferon β-1b (ExtaviPro® 30G and Betacomfort®). Nurses’ preferences were compared with those previously collected from patients using an identical questionnaire.ResultsThere were pronounced differences between practice settings and between countries in the opinions of MS nurses about their influence on treatment decision making. Nurses considered themselves instrumental in helping patients decide between treatment options offered by neurologists. Of the nine autoinjector attributes, nurses rated “reliable to use” as most important, followed by attributes associated with convenience (“easy to operate,” “ergonomic shape,” “reach” [of injection sites], and “one-handed injection”). Nurses’ and patients’ rankings of attributes were closely aligned. For the nine attributes, 74%–98% of nurses preferred ExtaviPro® 30G to Betacomfort®, 94% preferring ExtaviPro® 30G overall. Nurses showed a greater preference than patients for ExtaviPro® 30G with respect to “easy to operate” (92% vs 78%), “intuitive to use” (98% vs 78%), and “attractive design” (98% vs 83%; P<0.05, all), but preference rates were otherwise similar across the two groups. The most common reasons in both groups for preferring ExtaviPro® 30G to Betacomfort® were “easy to use” and “ergonomic shape.”ConclusionMS nurses play a key role in patient guidance and education. Their preferences for ExtaviPro® 30G likely reflect their understanding of the challenges patients face when self-administering treatment.

A Survey Study of the Usefulness and Concerns about Smart Home Applications from the Human Perspective

It is not yet clear how smart home technologies and applications will actually be accepted as part of our everyday lives. In this research, the thoughts of 248 people about smart homes were collected by interviews and with an Internet survey in Europe and Asia. It was found that people have very versatile thoughts about what the term “smart home” means in practice and when smart houses will become part of our daily lives. The Asian answerers can be considered to be slightly more optimistic about the schedule. The majority of the answerers were found to be interested in versatile smart home applications and willing to live in a smart house. The cost can be considered to be their biggest worry and the Asian answerers were found to be more worried about the reliability, practicability, and cost than the answerers from Europe. Also some privacy concerns were found from both the European and the Asian answerers.

Working Autonomy in Innovative Activities; Managing Knowledge Workers

Strategic management of human capital is critical in knowledge- intensive industries. Unlike the case of ordinary workers, incentivizing knowledge workers is a challenge since their performance is not exactly verifiable, and their innovative output is uncertain, and thereby, not contractble. We aim to test if working autonomy in practice is a motivation instrument for managing knowledge workers and tackling contractual hazards. For this purpose, we disentangle two distinct channels in which a firm may offer working autonomy to the worker; efficiency and incentive channel; an employer may delegate more autonomy to the worker to achieve higher productivity. At the same time, autonomy may be granted to better motivate the worker. Using the dataset of Inventors Survey in Europe, the U.S. and Japan (Innovative S&T)” we investigate the determinants of working autonomy for the category of knowledge and ordinary workers. Our results confirm a uniform effect of autonomy through efficiency channel for knowledge and...

Associations Between Changes in Anthropometric Measures and Mortality in Old Age: A Role for Mid-Upper Arm Circumference?

In elderly individuals, little is known about changes in different anthropometric measures with respect to mortality. We examined the association between changes in eight anthropometric measures and mortality in an elderly population. Longitudinal study including baseline measurements in 1988-1990 and repeated measures in1993. European towns. A total of 1061 older adults born in 1913-1918 from the Survey in Europe on Nutrition and the Elderly, A Concerted Action study were included in this study. Weight, body mass index, waist circumference, waist to hip ratio, waist to height ratio, mid-upper arm circumference (MUAC), triceps skinfold thickness, and corrected arm muscle area were taken during both measurements. A Cox regression model was used to examine the association between anthropometric changes (divided into quintiles, smallest change= reference category) and all-cause and cardiovascular disease mortality over approximately 6 years of follow-up, adjusted for baseline measurement of application, age, sex, smoking, education, physical activity, and major chronic diseases. A decrease in weight (≥3.2 kg), waist circumference (≥3.1 cm), and MUAC (≥1.6 cm and 0.6-1.6 cm) were (near) significantly associated with an all-cause mortality risk of 1.48 (95% CI: 0.99-2.20), 1.52 (95% CI: 1.01-2.31), 1.81 (95% CI: 1.17-2.79), and 1.66 (95% CI: 1.10-2.49), respectively. Also for MUAC, an increase (≥1.3 cm) was significantly associated with an increased all-cause and cardiovascular disease mortality risk [hazard ratio, 1.52 (95% CI: 1.00-2.31) and 1.94 (95% CI: 1.00-3.75), respectively]. Associations were observed for decreases in only 3 of 8 anthropometric measures and all-cause mortality. Decreases in MUAC had the strongest association with mortality and was the only measure in which an increase also was associated with mortality. This suggests a role for MUAC in the prediction of mortality in elderly individuals.

An investigation of the basic education of Japanese nurses: Comparison of competency with European nurses

A few studies have compared nursing education systems of Japan and Europe, particularly focusing on competency. We evaluated the competency of registered Japanese nurses by comparing it with that of European nurses; the implications of evaluation for the education of nurses are discussed. Subjects were 468 European graduate nurses and 100 Japanese nurses. Study used data from the Graduates in Knowledge Society (REFLEX) survey in Europe and the Japanese language version of REFLEX (2006) used in a survey of Japanese nurses. The questionnaire referred to the survey items of REFLEX modified for use in Japan. Items common to the Japanese and European surveys were (1) The importance placed on university course elements while at university (2) Nineteen items of competency: for the abilities acquired in the present job ('Acquired skills') and those considered necessary to perform the job ('Required abilities on the job') (3) Usefulness of subject matter taught at university to the current job (1) The important course elements in Europe were 'Internship, work placement' and 'Lecture' while those in Japan were 'Theories and paradigms' and 'Lecture'. (2) The mean values for 'Acquired skills' were 5.06 for Europe and 3.73 for Japan and those for 'Required abilities on the job' were 4.86 for Europe and 5.16 for Japan. In Europe, no significant gap was observed between the above two scores, but in Japan, a big gap was found, particularly in relation to 'Ability to assert your authority'. (3) In terms of the usefulness of university-learned nursing education, Japan scored significantly lower on all five items. The content of basic university education for nursing is directly linked to the workplace in Europe but not in Japan. A comparison of competencies shows that in Japan, self-evaluation scores are low and expectations are high.

Outcomes 'out of africa': the selection and implementation of outcome measures for palliative care in Africa

BackgroundEnd-of-life care research across Africa is under-resourced and under-developed. A central issue in research in end-of-life care is the measurement of effects and outcomes of care on patients and families. Little is known about the experiences of health professionals' selection and implementation of outcome measures (OM) in clinical care, research, audit, or teaching in Africa.MethodsAn online survey was undertaken of those using outcome measures across the region, as part of the PRISMA project. A questionnaire addressing the use of OMs was developed for a similar survey in Europe and adapted for Africa. Participants were sampled through the contacts database of APCA. Invitation emails were sent out in January 2010 and reminders in February 2010.Results168/301 invited contacts (56%) from 24 countries responded, with 78 respondents having previously used OM (65% in clinical practice, 12% in research and 23% for both). Main reasons for not using OM were a lack of guidance/training on using and analysing OM, with 49% saying that they would use the tools if this was provided. 40% of those using OM in clinical practice used POS, and 80% used them to assess, evaluate and monitor change. The POS was also the main tool used in research, with the principle criteria for use being validation in Africa, access to the tool and time needed to complete it. Challenges to the use of tools were shortage of time and resources, lack of guidance and training for the professionals, poor health status of patients and complexity of OM. Researchers also have problems analysing OM data. The APCA African POS was the most common version of the POS used, and was reported as a valuable tool for measuring outcomes. Respondents indicated the ideal outcome tool should be short, multi-dimensional and easy to use.ConclusionThis was the first survey on professionals' views on OM in Africa. It showed that the APCA African POS was the most frequently OM used. Training and support are needed to help professionals utilise OM in palliative care, and OMs have an ongoing and important role in palliative care in Africa.

Triple-S project: syndromic surveillance survey in Europe

Triple-S project: syndromic surveillance survey in Europe

Asthma in adults and its association with chronic rhinosinusitis: The GA2LEN survey in Europe

The prevalence of asthma and its association with chronic rhinosinusitis (CRS) have not been widely studied in population-based epidemiological surveys. The Global Allergy and Asthma Network of Excellence (GA(2) LEN) conducted a postal questionnaire in representative samples of adults living in Europe to assess the presence of asthma and CRS defined by the European Position Paper on Rhinosinusitis and Nasal Polyps. The prevalence of self-reported current asthma by age group was determined. The association of asthma with CRS in each participating centre was assessed using logistic regression analyses, controlling for age, sex and smoking, and the effect estimates were combined using standard methods of meta-analysis. Over 52,000 adults aged 18-75 years and living in 19 centres in 12 countries took part. In most centres, and overall, the reported prevalence of asthma was lower in older adults (adjusted OR for 65-74 years compared with 15-24 years: 0.72; 95% CI: 0.63-0.81). In all centres, there was a strong association of asthma with CRS (adjusted OR: 3.47; 95% CI: 3.20-3.76) at all ages. The association with asthma was stronger in those reporting both CRS and allergic rhinitis (adjusted OR: 11.85; 95% CI: 10.57-13.17). CRS in the absence of nasal allergies was positively associated with late-onset asthma. Geographical variation in the prevalence of self-reported asthma was observed across Europe, but overall, self-reported asthma was more common in young adults, women and smokers. In all age groups, men and women, and irrespective of smoking behaviour, asthma was also associated with CRS.

The impact of body mass index in old age on cause-specific mortality.

To assess the association between Body Mass Index (BMI) and cause-specific mortality in older adults and to assess which BMI was associated with lowest mortality. Prospective study. European towns. 1,980 older adults, aged 70-75 years from the SENECA (Survey in Europe on Nutrition and the Elderly: a concerted action) study. BMI, examined in 1988/1989, and mortality rates and causes of death during 10 years of follow-up. Cox proportional hazards model including both BMI and BMI², accounting for sex, smoking status, educational level and age at baseline showed that BMI was associated with all-cause mortality (p<0.01), cardiovascular mortality (p<0.01) and mortality from other causes (p<0.01), but not with cancer or respiratory mortality (p>0.3). The lowest all-cause mortality risk was found at 27.1 (95%CI 24.1, 29.3) kg/m², and this risk was increased with statistical significance when higher than 31.4 kg/m² and lower than 21.1 kg/m². The lowest cardiovascular mortality risk was found at 25.6 (95%CI 17.1, 28.4) kg/m², and was increased with statistical significance when higher than 30.9 kg/m². In this study, BMI was associated with all-cause mortality risk in older people. This risk was mostly driven by an increased cardiovascular mortality risk, as no association was found for mortality risk from cancer or respiratory disease. Our results indicate that the WHO cut-off point of 25 kg/m² for overweight might be too low in old age, but more studies are needed to define specific cut-off points.

Country differences in patient characteristics and treatment in schizophrenia: data from a physician-based survey in Europe

Schizophrenia is a frequent psychiatric disorder whose prevalence appears to be relatively stable across different patient groups. However, attitudes to care and resources devoted to mental health care may differ between countries. The objective of this analysis was to compare sociodemographic and psychopathological features of patients, antipsychotic treatment and frequency of hospitalisation between four European countries (Germany, Greece, Italy and Spain) collected as part of a large survey of the characteristics of patients with schizophrenia. The survey was conducted by structured interview of 744 randomly-selected psychiatrists in four European countries who recruited 3996 patients. Information on 39 variables was collected. A number of between-country differences were observed which tended to distinguish Germany on the one hand, from the Mediterranean countries, and Greece in particular, on the other. While demographic features and clinical features were essentially similar, more patients in Germany were considered to have severe disease by their psychiatrist (59.0% versus 35.9% in Greece) and to be hospitalised (49.3% versus 15.0%). 46.7% of German patients were living alone compared to less than 20% in the Mediterranean countries and 50.2% were living with their family ( versus over70% elsewhere). Smoking and addictive behaviours were more frequently reported for patients in Spain. With regard to empirically derived patient subgroups, Subgroup 2, corresponding to well-integrated and autonomous patients with mild to moderate disease severity was most highly represented in Greece (23.6% of patients compared to less than 10% elsewhere) elsewhere, Subgroup 6 (poorly-integrated patients with moderately severe disease who require caregiver support) was under-represented in Germany (4.5% versus over 17% elsewhere). Patterns of treatment were essentially similar, although quetiapine was more frequently prescribed and paliperidone less frequently prescribed in Germany than elsewhere. Reasons for treatment choice were comparable between countries, primarily related to good tolerability and control of positive symptoms. The differences observed may be attributed to differences in mental health care resource provision, socio-cultural or educational differences or to resource issues.

Current Controversies in Spondyloarthritis: SPARTAN

The Spondyloarthritis Research and Therapy Network (SPARTAN), founded in 2003 to promote research, education, and treatment of ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA), held its 7th Annual Research and Education Meeting in July 2009 in Houston, Texas. Current controversies in SpA discussed during the meeting included an update on the epidemiology of AS, axial SpA, and inflammatory back pain; the adequacy of the mSASS to assess radiographic involvement; the helpfulness of magnetic resonance imaging in assessing disease progression; the reliability of metrology in assessing damage; and whether biologic agents alter the course of AS. Presentations also were made on psoriasis in the SCID mouse model; the challenges and opportunities of SpA in China; a discussion of the special needs in managing SpA in Ibero-America, and the SPARK Survey in Europe and North America.

Erratum to: Bio-medicolegal guidelines and protocols: survey and future perspectives in Europe

G. VielDepartment of Environmental Medicine and Public Health,Institute of Legal Medicine, University-Hospital of Padua,Via Falloppio, 50,35121 Padua, Italye-mail: santodavide.ferrara@unipd.itT. BajanowskiInstitute of Legal Medicine,University-Hospital Essen,Hufelandstrasse 55,45122 Essen, GermanyR. CecchiDepartment of Legal Medicine,University of Rome “La Sapienza”,Viale Regina Elena 336,00161 Rome, ItalyInt J Legal Med (2010) 124:671DOI 10.1007/s00414-010-0481-1

Bio-medicolegal guidelines and protocols: survey and future perspectives in Europe

The preservation of uniqueness and the enhancement of the value of evidence in legal medicine is based on the implementation and development of a "quality management system," which includes a continuous education of specialists, the introduction and application of guidelines and protocols, as well as mechanisms of internal quality control. This ongoing process shows differences with regard to various fields of knowledge such as forensic genetics, toxicology, forensic pathology or forensic psychiatry, especially if different European countries are compared. To get an overview on the development of legal medicine in different European countries, a questionnaire was developed and sent to representatives of 42 European countries to verify the existence of bio-medicolegal guidelines and protocols. A National Society of Legal Medicine is established in 27 out of 32 countries (84%) which could be included in the final analyses. In 25 countries (78%), a specialisation is necessary as a prerequisite of inclusion in a national register, and 30 of the countries (94%) have guidelines in at least one field of legal medicine. The most common guidelines concern forensic pathology (in the fields of professional qualification and sudden death), forensic toxicology (driving under the influence of drugs and substance testing) and forensic genetics (paternity testing and personal identification). The findings of this study show that comparison is possible and can be a basis for further consensus in the European medicolegal community. The process of harmonisation of the medicolegal autopsy rules in Europe initiated in 1990 was a first step on this way. Further consensus is necessary and might be gained by developing European guidelines for each field within the subdisciplines, based on a standard European Guideline Format.

Factors influencing the sound preference in urban open spaces

In this paper, based on a large scale survey in Europe and China as well as corresponding laboratory studies, the influencing factors on the sound preference evaluation, considering social, demographical, physical, behavioural and psychological facets, have been systematically examined based on statistical analyses for each of the 19 case study sites. Various sound types have been considered, including natural, human, mechanical and instrumental sounds. In terms of social/demographical factors, the results suggest that age and education level are two factors which universally influence the sound preference significantly, although the influence may vary with different types of urban open spaces and sounds. With increasing age or education level, people tend to prefer natural sounds and are more annoyed by mechanical sounds in general. It has also been found that gender, occupation and residence status generally would not influence the sound preference evaluation significantly, although gender has a rather strong influence for certain sound types such as bird sounds, especially at certain case study sites. In terms of physical factors (season, time of day), behavioural factors (frequency of coming to the site, reason for coming to the site), and psychological factors (site preference), generally speaking, their influence on the sound preference evaluation is insignificant, except for limited case study sites and certain sound types. The influence of home sound environment, in terms of sounds heard at home, on the sound preference has been found to be generally insignificant, except for certain sounds. It is noted that there are some correlations between social/demographical factors and the studied physical/behavioural/psychological factors, which should be taken into account when considering the influence of individual factors on sound preference.

A European survey of noninvasive ventilation practices

Although noninvasive ventilation (NIV) is becoming very popular, little is known about its pattern of clinical and technical utilisation in different environments. We conducted a web-based survey in Europe to identify the perceived pattern of NIV utilisation and the reason for choosing a specific ventilator and interface type in four common clinical scenarios: acute hypercapnic respiratory failure (AHRF), cardiogenic pulmonary oedema (CPE), de novo hypoxic respiratory failure and weaning/post-extubation failure (W/PE). A response was obtained from 272 (51.3%) out of 530 selected European physicians involved in NIV practice. The NIV utilisation rate was higher for pulmonologists than intensivists/anesthesiologists (p<0.05). The most common indication for all the physicians was AHRF (48%). Physicians were more likely to use NIV dedicated ventilator in AHRF and CPE and an intensive care unit (ICU) ventilator with NIV module in de novo hypoxic respiratory failure and W/PE, mainly because of the possibility of using the double circuit and inspiratory oxygen fraction control. Overall, the oro-nasal mask was the most frequently used interface, irrespective of clinical scenarios. The use of NIV in Europe is generally relatively high, especially among pulmonologists and in AHRF. Dedicated NIV ventilators and ICU ventilators with NIV modules are preferably in AHRF and in de novo hypoxic respiratory failure, respectively, together with oro-nasal masks.

Dietary carbohydrates and change in physical performance of elderly Europeans: Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA) 1993 and 1999

To study dietary glycaemic index (GI) and glycaemic load (GL) in association with physical performance in elderly Europeans. Cross-sectional and prospective study. Physical performance was measured using the Physical Performance Test (PPT) score on a scale from 0 to 27, where high scores indicate a better physical performance. Habitual diets were measured using diet history interviews and dietary GI and GL were estimated from table values. Eight towns/centres from the Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA) in 1993 and 1999. Seven hundred and sixty-five men and women, 75-80 years old, were examined in 1993; of these, 357 (47 %) were followed up in 1999, at age 80-85 years. At baseline, both dietary GI and GL were significantly inversely associated with PPT scores (P = 0.03 and P = 0.05, respectively). When adjusted for age, BMI, physical activity, self-perceived health, chronic diseases and town/centre, the strength of the associations was attenuated and became non-significant (GI, P = 0.08; GL, P = 0.92). Dietary GI/GL were not associated with PPT scores 6 years later. Among elderly Europeans, a high glycaemic diet was associated with a low physical performance at baseline but not 6 years later. Cross-sectional associations may in part be caused by variations in age, BMI, physical activity, self-perceived health, chronic diseases and geographic location.

Is informed choice in prenatal testing universally valued? A population‐based survey in Europe and Asia

Informed choice has become an integral part of healthcare provision. We investigated the extent to which informed choice in the context of prenatal testing is universally valued. The value attached to parental choice in prenatal testing and the perceived importance of significant others' views when making test decisions were assessed in a cross-sectional, descriptive study. Male and female participants from general population samples in six countries: the UK (n = 210), the Netherlands (n = 197), Italy (n = 200), Greece (n = 200), China (n = 200) and India (n = 199). The questionnaires assessed values attached to parental involvement and the perceived importance of the views of significant others when making prenatal test decisions. Attitudes towards parental choice and attitudes towards the importance of others' views were analysed by age, gender and education using Chi-squared tests, Analysis of Variances and multiple logistic regression. The majority of respondents from Northern European countries believed that undergoing prenatal tests should reflect parental choice. Conversely, only a minority of respondents from Southern European and Asian countries advocated parental choice, with most expressing the belief that all pregnant women should have the procedure. The perceived importance of significant others' views when making test decisions also varied across countries: those in favour of parental choice perceived others' views as less important in the test decision. A preference for prenatal testing decisions to reflect an informed choice was predicted by (i) country and (ii) the perceived importance of significant others' views. Education, age and gender did not predict decisions. The implications of these findings for policy and practice depend upon whether placing a low value on parental choice, but a high value on the others' views regarding prenatal testing is considered an informed choice. Further research is needed to determine whether cultural variation in values remains significant in a multicultural society.

Impact of headache in Europe: a review for the Eurolight project

A recent health economic survey in Europe has suggested that migraine is the costliest among the neurological disorders. According to many studies, migraine and other disorders lead to widespread suffering, reduction of quality of life, and marked impairment of participation, both in work and social activities. The present literature survey was made in order to summarize what is known on the subject, as a preparation for a EU-supported study to assess the impact in several EU countries with similar methodology and the same research instrument. Previous studies have yielded relatively reliable data only for migraine, whereas the impact of tension-type headache is virtually unknown or only very incompletely known for most dimensions of headache impact. Some data do suggest, however, that this headache may be as important from a health economic and a public health perspective as migraine. In future studies it is important to get population-based data from various countries relevant for estimation of indirect (mostly absenteeism from work and reduced working efficiency when having headache) and direct costs (related to medication, consultations, investigations and hospitalisations). Also, the impact on ability to get education and participate in the workforce is very relevant, as is the impact on love life and family planning. The quality of life of headache patients should be measured by validated instruments. To get a complete picture, one should also ask about the effect on the life of partners and children, and on the possible impact even when headache-free (e.g. fear of the next attack).

Comparative study of screening methodologies for ochratoxin A detection in winery by-products

The worldwide contamination of winery by-products by mycotoxins may present a serious hazard to human and animal health. Mycotoxins are secondary metabolites of fungi with possible adverse effects on humans, animals, and crops that result in illnesses and economic losses. Mycotoxins are under continuous survey in Europe, but the regulatory aspects still need to be set up for winery by-products, which may be used in animal feed. The aim of this study was to implement a simple but reliable analytical methodology for ochratoxin A (OTA) quantification in grape pomaces in order to perform a survey of samples from the Douro Demarcated Region, Portugal. The method involved a unique preparation step, solvent extraction, followed by high-performance liquid chromatography (HPLC) with fluorescence (FL) detection. A comparative study was performed with two extraction solvents (ethyl acetate and methanol) as well as using extraction on an immunoaffinity column. The linearity range for OTA analysis was 0.05-23.5 microg L(-1) with a detection limit of 0.05 microg L(-1) and a precision (expressed by the coefficient of variation under repeatability conditions) of 0.4-14.7%. The percentage of recovery was on average 23.5 +/- 3.6% (extraction with ethyl acetate) or 70.1 +/- 2.5% (extraction with 70% methanol). Accounting for the recovery factor and the chromatographic detection limit, as well as the preconcentration factor, the limit of detection in grape pomaces is 0.04 microg kg(-1) (ethyl acetate extraction) and 0.33 microg kg(-1) (methanol extraction). Samples from 12 out of 13 sites in the Douro Demarcated Region showed OTA presence with concentrations not exceeding 0.4 microg kg(-1). Both developed methods for evaluation of OTA in grape pomace are simple but efficient.

The molecular characterisation of Giardia from dogs in southern Germany

Faecal samples were obtained randomly from asymptomatic dogs visiting veterinary clinics (kept individually) and sanctuaries (kept in groups) in southern Germany. Of 60 Giardia positive samples, 55 samples successfully amplified at the 18S rDNA locus. In both dogs kept individually and dogs kept in groups, assemblage A was most prevalent (overall, n = 33, 60%), followed by mixed infections with assemblages A&C (overall, n = 15, 27.3%), while assemblages C&D alone were less often detected (overall, n = 5, 9.1% and n = 2, 3.6%). The occurrence of zoonotic genotypes was more prevalent in individual than in group dogs. Genotyping at the gdh locus confirmed the 18S results and clustered the assemblage A isolates into A–I. This is the first large-scale urban survey in Central Europe, which has not only confirmed the high prevalence of Giardia in asymptomatic domestic dogs, but has also shown that the zoonotic assemblage A occurs commonly in domestic dogs living in urban environments, and more frequently than the dog-specific assemblage. Although it was not possible to obtain samples from pet owners in this study, the results demonstrate that a significant proportion of dogs in urban areas of southern Germany harbour zoonotic Giardia, and should thus be considered a potential reservoir for infection in humans.