Guidelines for paediatric life support. Paediatric Life Support Working Party of the European Resuscitation Council.

The paediatric life support working party of the European Resuscitation Council was set up in 1992 with the aim of producing guidelines for basic and advanced paediatric resuscitation that would be acceptable throughout Europe. The commonest cause of cardiac arrest in children is problems with the airway. The resulting difficulties in breathing and the associated hypoxia rapidly cause a severe bradycardia or asystole. In contrast, adults have primary cardiac events resulting in ventricular fibrillation. This important difference in the pathogenesis of paediatric and adult cardiac arrest is reflected in these European Resuscitation Council guidelines, which complement those already published for adults.     

Adult advanced cardiac life support: the European Resuscitation Council guidelines 1992 (abridged). European Resuscitation Council Working Party.

The European Resuscitation Council, established in 1990, is committed to saving lives by improving standards of cardiopulmonary resuscitation across Europe and coordinating the activities of interested organisations and individuals. In this regard the council has successfully brought together physicians and surgeons from eastern and western Europe and, in addition, has established relations with the American Heart Association and equivalent organisations in Canada, Australia, and South Africa. A main objective of the European Resuscitation Council is to produce guidelines for cardiopulmonary and cerebral resuscitation, and in this paper members of a working party of 14 experts from 11 countries set out an abridged version of the council''s guidelines for adult advanced cardiac life support. The council hopes that the guidelines and accompanying algorithms will serve as a ready use "how to do it" for ordinary practitioners and paramedics inside and outside hospital.     

Resuscitation from cardiac arrest: assessment of a system providing only basic life support outside of hospital

Resuscitation outside of hospital of victims of cardiac arrest is a major challenge to our emergency care system. Most cities in Canada do not have a mobile advanced life support service; instead they rely on basic life support outside of hospital. The outcome in such cases and the factors affecting the outcome are largely unknown. Thus, it is difficult to estimate the lifesaving potential of adding advanced life support to the existing measures available for care outside of hospital.A prospective study of all resuscitation attempts begun outside of hospital was conducted during 18 consecutive months in 1977-78 in Winnipeg; at that time only basic life support was available outside of hospital. Resuscitation was attempted 849 times, and 33 patients (4%) survived to be discharged from hospital. Data analysis revealed that: (a) none of the 58% of patients in asystole at the time of arrival at a hospital survived to be discharged, but 11% of the patients with ventricular fibrillation or tachycardia (27% of the entire group) survived; (b) the survival rate was lower when the interval from the emergency telephone call to the patient''s arrival at the hospital exceeded 10 minutes; and (c) basic life support was begun immediately in 29% of the patients with ventricular fibrillation or tachycardia, and increased the survival rate fivefold.The training of private citizens in basic life support is a vital component of total emergency cardiac care. A mobile advanced life support service will be effective in saving lives if it reduces the delay before definitive care is instituted, preferably to less than 10 minutes.     

EFOMP survey results on national radiotherapy dosimetry audits

PurposeThe Council Directive 2013/58/EURATOM entered into force in 2014, and its transposition into national legislations became applicable in 2018. The Council Directive 2013/58/EURATOM strengthened the importance of clinical audits, and stated that Member States should ensure dosimetry audit compliance in accordance with national procedures. Therefore, the purpose of this work was to picture the status of the implementation of dosimetry audits in European countries. Methods: A questionnaire was designed to describe dosimetry audit standards in radiotherapy across European countries. The questionnaire was sent to 33 EFOMP National Member Organizations (NMO). Results: Nineteen NMOs responded to the survey (14 EU members). For 58% of the participating countries national regulations required dosimetry audits in radiotherapy departments. In 37% of the participating countries there were implemented regulations for independent/secondary dose verification, and in 21% of the participating countries similar procedures for dose verification were already implemented although not regulated by law. In 42% of the participating countries there were implemented mechanisms to review updates and advances in the field of radiotherapy.ConclusionsThe transposition and further implementation of the Council Directive 2013/59/EURATOM was scarce, leading to heterogeneities in national policies about dosimetry audits.     

Cancer incidence vs. FM radio transmitter density

ABSTRACT

Background: In 2002, a strong association was highlighted between local melanoma incidence and the number of locally covering main Frequency Modulation (FM) transmitters in Sweden. This study investigated whether an association also exists between melanoma incidence and the average density of main FM transmitters in different European countries. Methods: Twenty-three different European countries were asked to disclose the number of main transmitters used for the FM broadcasting band (87·5–108 MHz) in the respective country. Incidences of melanoma, breast cancer and all cancers together per country were correlated with their respective average density of transmitters per 10,000 km². Findings: Both melanoma and breast cancer, as well as all cancers together, appear to be significantly associated with the density of main FM broadcasting transmitters in the European countries examined. Interpretation: The findings present strong support to the earlier presented hypothesis that body-resonant broadcasting radiation emitted by horizontally polarized main FM transmitters has an immune-disturbing effect. Funding: This study was financed by internal funds within Hallberg Independent Research only.     

NATURA 2000 – The influence of the European directives on the development of nature-based sport and outdoor recreation in mountain areas

In all member countries of the European Community, the influence of European directives is increasing. This is especially the case with directives on the conservation of natural habitats and wild fauna and flora (European Council Directive 92/43 EEC from 1992 (Council of the European Union 1992) and the directive on the conservation of wild birds (European Council directive 79/409 EEC from 1979 (Council of the European Union 1979). These directives are expected to influence the future development of nature-based sport and outdoor recreation significantly. Many German sport organisations are expecting negative consequences for the future development of nature-based sport in mountain areas. This paper summarises key findings of a study commissioned by the German Sport Association.

This project develops guidelines for the application and interpretation of these directives, as well as for their practicable use and management. The study shows that the potential negative effects of nature-based sport and outdoor recreation activities can be categorised into three general types. Furthermore, large sport events should be evaluated separately in the future. Finally, the crucial role of management plans is discussed, which are essential if NATURA 2000 areas are to be established successfully. The management plan assists in the selection of suitable measures, helps to resolve conflicts, and increases the level of acceptance and its transparency for the public. This paper will demonstrate that the consultation and participation of local people including members of sport and recreational organisations is essential to achieve the best result in the interest of nature conservation in general and conservation of endangered habitats or species specifically.     

Exploring diversity among Spanish strains of Erwinia amylovora and possible infection sources

AIMS: We have examined the intraspecific diversity of a collection of 63 Spanish strains of Erwinia amylovora, isolated from 1995 to 2001, to determine whether or not they could be grouped based on phenotypic or genotypic criteria and to investigate the sources of inoculum for fire blight dissemination in Spain. METHODS AND RESULTS: Several biochemical and molecular techniques, such as miniaturized API 20E, API 50CH, ATB G-5 and API-ZYM tests, BIOLOG metabolic fingerprinting, PCR ribotyping, pulsed-field gel electrophoresis (PFGE), minisatellite-primed PCR (MSP-PCR), random amplified polymorphic DNA (RAPD) analyses and AFLP were used. We report the first identification in Spain of the PFGE pattern Pt1, already described in other European countries, together with Pt3 and Pt4 patterns. Moreover, PFGE, together with MSP-PCR, RAPD analyses and AFLP are, until now, the only techniques that have provided information about the possible infection sources and relationships between the different foci in Spain, with AFLP being the most discriminative. CONCLUSIONS: These techniques have allowed grouping of Spanish strains by their geographical origin. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results support the hypothesis that some fire blight outbreaks have been caused by the introduction in Spain of infected plant material, or other inoculum sources from different European countries.     

Pharmacogenetics: Ethical Issues

Books reviewed:
Pharmacogenetics: Ethical Issues , Report by the Nuffield Council on Bioethics. London: Nuffield Council on Bioethics. 2003. xxiv + 103pp. £10 to all European countries (including postage); £15 to non-European countries (including postage); £0 to developing countries. Available free of charge at: http://www.nuffieldbioethics.org/filelibrary/pdf/pharmacogenetics_report     

A community training scheme in cardiopulmonary resuscitation.

Community instruction in basic life support and resuscitation techniques has been offered in Brighton Health District since 1978. Classes are held frequently for the general public and businesses, schools, and other organisations. First aid care for unconscious patients, the treatment of respiratory obstruction or failure, and the recognition and management of cardiac arrest is taught in a single two hour session. Over 20 000 people have been taught, up to 40 at a time in multiple groups of six to eight, by lay instructors usually supervised by ambulancemen trained to "paramedic" standards. Fifty four incidents have been reported to us in which techniques learnt in the classes have been implemented. Five patients recovered after first aid support but subsequently did not seek medical treatment. Of the 34 patients reviewed in hospital, at least 20 survived to be discharged. We believe that intervention may have been life saving in 16 instances. The benefit of cardiopulmonary resuscitation for victims who may have been asystolic is, however, difficult to quantify because the outcome without intervention cannot be predicted accurately. Community training in basic life support should be considered in association with ambulances equipped for resuscitation and hospital intensive care and cardiac care units as an integrated service for the victims of sudden circulatory or respiratory emergencies. The results achieved so far in Brighton and in other more advanced schemes, particularly in the United States of America, may encourage other health authorities to adopt similar programmes.     

The European Federation of Organisations for Medical Physics. Policy Statement No. 12: The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations

A recently published EFOMP's survey on the status of Education and Training in Europe, has showed the important role played by the NMOs in the organisation of the Medical Physics education and training in most countries and their efforts to fulfil EFOMP recommendations. However, despite of this, there is still a wide variety of approaches within Europe, not only in the education and training programmes but also in professional practice.There is right now some European issues that can affect not only education and training but also the future of Medical Physics as a profession: 1. the harmonisation of the architecture of the European Higher Education System, arising from the “Bologna Declaration”, for 2010, 2. the recently issued European directive: “Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications”.EFOMP is now challenged to make recommendations for education and training in Medical Physics, within the context of the current developments in the European Higher Education Area arising from “The Bologna Declaration”, and with a view to facilitate the free movement of professionals within Europe, according to the new Directive.     

The genetics of coronary heart disease: the contribution of twin studies.

Despite the decline in coronary heart disease in many European countries, the disease remains an enormous public health problem. Although we know a great deal about environmental risk factors for coronary heart disease, a heritable component was recognized a long time ago. The earliest and best known examples of how our genetic constitution may determine cardiovascular risk relate to lipoprotein(a), familial hypercholesterolaemia and apolipoprotein E. In the past 20 years a fair number of polymorphisms assessed singly have shown strong associations with the disease but most are subject to poor repeatability. Twins constitute a compelling natural experiment to establish the genetic contribution to coronary heart disease and its risk factors. GenomEUtwin, a recently funded Framework 5 Programme of the European Community, affords the opportunity of comparing the heritability of risk factors in different European Twin Registries. As an illustration we present the heritabilities of systolic and diastolic blood pressure, based on data from over 4000 twin pairs from six different European countries and Australia. Heritabilities for systolic blood pressure are between 52 and 66% and for diastolic blood pressure between 44 and 66%. There is no evidence of sex differences in heritability estimates and very little to no evidence for a significant contribution of shared family environment. A non-twin based prospective case/cohort study of coronary heart disease and stroke (MORGAM) will allow hypotheses relating to cardiovascular disease, generated in the twin cohorts, to be tested prospectively in adult populations. Twin studies have also contributed to our understanding of the life course hypothesis, and GenomEUtwin has the potential to add to this.     

Conservation gains through HCVF assessments in Bosnia-Herzegovina and Romania

This paper analyses the conservation gains through High Conservation Value Forest (HCVF) assessments in two South-East European countries (Bosnia-Herzegovina and Romania). These are based on the review of the Draft Forest Stewardship Council (FSC) National Standards and HCVF Manuals and the results of the certification process of seven forest management units in the two countries. The review indicates that the application of Principle 9 (High Conservation Value Forests) and Criterion 6.4 of the FSC in Bosnia-Herzegovina and Romania was influenced by the size and nature of tenure (i.e., public or non-public land), rather than geographic location per se. The study also revealed that the assessment of HCVF has, for the first time, raised the question of conservation of cultural, historical and religious values as well as the sustainable management of those forests relevant for the basic needs of communities. These are values not currently covered at the present by the national conservation legislation in either of these two countries. Findings of this study in both countries demonstrates that there are certain conservation gains as a result of the HCVF assessment, especially related to ecosystem services, prevention of soil erosion and conservation of threatened, endangered and endemic species.     

Comparative development of knowledge-based bioeconomy in the European Union and Turkey

Abstract

Biotechnology, defined as the technological application that uses biological systems and living organisms, or their derivatives, to create or modify diverse products or processes, is widely used for healthcare, agricultural and environmental applications. The continuity in industrial applications of biotechnology enables the rise and development of the bioeconomy concept. Bioeconomy, including all applications of biotechnology, is defined as translation of knowledge received from life sciences into new, sustainable, environment friendly and competitive products. With the advanced research and eco-efficient processes in the scope of bioeconomy, more healthy and sustainable life is promised. Knowledge-based bioeconomy with its economic, social and environmental potential has already been brought to the research agendas of European Union (EU) countries. The aim of this study is to summarize the development of knowledge-based bioeconomy in EU countries and to evaluate Turkey’s current situation compared to them. EU-funded biotechnology research projects under FP6 and FP7 and nationally-funded biotechnology projects under The Scientific and Technological Research Council of Turkey (TUBITAK) Academic Research Funding Program Directorate (ARDEB) and Technology and Innovation Funding Programs Directorate (TEYDEB) were examined. In the context of this study, the main research areas and subfields which have been funded, the budget spent and the number of projects funded since 2003 both nationally and EU-wide and the gaps and overlapping topics were analyzed. In consideration of the results, detailed suggestions for Turkey have been proposed. The research results are expected to be used as a roadmap for coordinating the stakeholders of bioeconomy and integrating Turkish Research Areas into European Research Areas.     

TRANSAUTOPHAGY: European network for multidisciplinary research and translation of autophagy knowledge

A collaborative consortium, named “TRANSAUTOPHAGY,” has been created among European research groups, comprising more than 150 scientists from 21 countries studying diverse branches of basic and translational autophagy. The consortium was approved in the framework of the Horizon 2020 Program in November 2015 as a COST Action of the European Union (COST means: CO-operation in Science and Technology), and will be sponsored for 4 years. TRANSAUTOPHAGY will form an interdisciplinary platform for basic and translational researchers, enterprises and stakeholders of diverse disciplines (including nanotechnology, bioinformatics, physics, chemistry, biology and various medical disciplines). TRANSAUTOPHAGY will establish 5 different thematic working groups, formulated to cooperate in research projects, share ideas, and results through workshops, meetings and short term exchanges of personnel (among other initiatives). TRANSAUTOPHAGY aims to generate breakthrough multidisciplinary knowledge about autophagy regulation, and to boost translation of this knowledge into biomedical and biotechnological applications.     

Appraisal of pediatric cardiopulmonary resuscitation.

Sixty-six patients more than 30 days and less thant 16 years of age suffering an unexpected cardiac arrest in an 18-month period were included in a study of resuscitative measures in children. Six children survived to be discharged from hospital. Respiratory disease accounted for most (29%) of the cardiac arrests, but it also had the most favourable prognosis, 21% of the 19 patients surviving. None of the patients survived whose cardiac arrest was secondary to sepsis or trauma, even when the resuscitative efforts were initially successful. Only 1 of the 41 patients who had a cardiac arrest outside of hospital survived, and only 1 of the 34 patients who presented with asystole survived, and then with considerable damage to the central nervous system. The interval between cardiac arrest and application of basic life support was substantially shorter among the survivors. Also, most of the survivors did not present with asystole. The results of this study suggest that survival among resuscitated children is no better than that among adults but can be improved with early recognition and monitoring of children at risk. earlier application of basic and advanced life support, improved education of medical and lay personnel, and further research into pediatric resuscitative techniques.     

Culture and end of life care: a scoping exercise in seven European countries

Aim

Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries.

Methods

We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes.

Results

A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities.

Conclusion

This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.     

Health and environment in Czechoslovakia.

The study summarizes basic information on environmental conditions and health status of the Czechoslovak population. It analyzes the relationships between health and environmental conditions, and Appendix brings the comprehensive results of relevant studies performed in Czechoslovakia. The analytic results suggest the quality of Czechoslovak ecology as unsatisfactory, which in some localities, e.g. North Bohemia coal fields, Prague, Ostrava, is next to critical, with heavy impact on the population's health. The Czechoslovak citizens are more prone to falling ill, die sooner than their peers in the majority of European and non-European countries. In addition to the specific effects of individual factors and life style also immunity, reproduction cycle, metabolic processes etc. become involved in the health-living conditions relationships. All these influences are responsible for high rates of morbidity due to the so-called civilization diseases. Inevitably, the only possible solution is to protect effectively human healthy by protecting his living conditions, i.e. environment and life style.     

Evaluation of phenotypic and molecular typing techniques for determining diversity in Erwinia carotovora subspp. atroseptica

A number of phenotypic and molecular fingerprinting techniques, including physiological profiling (Biolog), restriction fragment length polymorphism (RFLP), enterobacterial repetitive intergenic consensus (ERIC) and a phage typing system, were evaluated for their ability to differentiate between 60 strains of Erwinia carotovora ssp. atroseptica (Eca) from eight west European countries. These techniques were compared with other fingerprinting techniques, random amplified polymorphic DNA (RAPD) and Ouchterlony double diffusion (ODD), previously used to type this pathogen. Where possible, data were represented as dendrograms and groups/subgroups of strains identified. Simpson's index of diversity (Simpson's D) was used to compare groupings obtained with the different techniques which, with the exception of Biolog, gave values of 0.46 (RFLP), 0. 39 (ERIC), 0.83 (phage typing), 0.82 (RAPD) and 0.26 (ODD). Of the techniques tested, phage typing showed the highest level of diversity within Eca, and this technique will now form the basis of studies into the epidemiology of blackleg disease.     

The European Federation of Organisations for Medical Physics Policy Statement No. 6.1: Recommended Guidelines on National Registration Schemes for Medical Physicists

This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and the European Union Council Directive 2013/59/EURATOM laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation. The European Commission Radiation Protection Report No. 174, Guidelines on Medical Physics Expert and the EFOMP Policy Statement No. 12.1, Recommendations on Medical Physics Education and Training in Europe 2014, are also taken into consideration.The EFOMP National Member Organisations are encouraged to update their Medical Physics registration schemes where these exist or to develop registration schemes taking into account the present version of this EFOMP Policy Statement (Policy Statement No. 6.1“Recommended Guidelines on National Registration Schemes for Medical Physicists”).     

British and European Legislation Regulating Rhabditid Nematodes

Rhabditid nematodes are invertebrates that introduce pathogenic bacteria to the insects and molluscs they parasitise. Marketed as biopesticides, they provide safe and effective alternatives to chemical pesticides in several important sectors of horticulture. In Great Britain, the introduction of non-indigenous species of nematodes is strictly controlled, as is the contained use and deliberate release of genetically modified nematodes and their bacterial symbionts. Currently, indigenous, unmodified nematodes do not have to be registered for use as biopesticides in the UK, but in some other European countries registration is mandatory. The European Commission is seeking to harmonize procedures for the authorization of plant protection products, including rhabditid nematodes, under the provisions of Council Directive 91/414/EEC.