scholarly journals Increased Risk of RSV Infection in Children with Down's Syndrome: Clinical Implementation of Prophylaxis in the European Union

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Dianne van Beek ◽  
Bosco Paes ◽  
Louis Bont
Keyword(s):  
European Union ◽  
Down's Syndrome ◽  
Healthcare Providers ◽  
Down’S Syndrome ◽  
The European Union ◽  
Clinical Implementation ◽  
Increased Risk ◽  
Rsv Infection ◽  
Current Guidelines ◽  
Country Specific

Prospective cohort studies show that Down’s syndrome (DS) is an independent risk factor for hospitalization for RSV bronchiolitis. It is unknown whether this observation has been translated into specific management for DS children. The primary goal was to assess the knowledge of healthcare providers in the European Union about RSV infection in DS children and to determine whether it influenced the implementation of prophylaxis. DS caregivers were surveyed using a standardized questionnaire, and country-specific guidelines were obtained. Fifty-three caregivers participated. Thirty-nine (86.7%) had knowledge of the increased risk of severe RSV infection in DS children, and 30 (71.4%) graded that it was important to have a statement on the use of RSV prophylaxis in existing guidelines. Twenty-eight participants had a local DS guideline; hard copies of twelve unique guidelines were obtained. Only one (8.3%) contained a statement on RSV prophylaxis for DS, and five considered such a statement for the next version.Conclusion. Most pediatricians had knowledge that DS children have an increased risk of severe RSV infection. Despite the lack of a specific RSV prophylaxis trial in DS, they felt that a statement on RSV prophylaxis in DS guidelines was important, but this was rarely present in current guidelines.

Derivation of Clearance Levels for the New German Radiation Protection Ordinance

2001 ◽  
Author(s):  
Stefan Thierfeldt ◽  
Ernst Kugeler ◽  
Alexander Nüsser ◽  
Renate Sefzig ◽  
Hans-Henning Landfermann ◽  
...  
Keyword(s):  
European Union ◽  
Waste Management ◽  
Boundary Conditions ◽  
Radiation Protection ◽  
The European Union ◽  
Individual Dose ◽  
Management Options ◽  
Full Agreement ◽  
Safety Standards ◽  
Country Specific

Abstract The new Radiation Protection Ordinance (RPO) in Germany which transforms the EURATOM Basic Safety Standards into national legislation contains detailed regulations on clearance. For each of the following clearance options, a separate set of clearance levels (CL) exists: unconditional clearance, clearance of building rubble (> 1000 Mg/a), clearance of buildings for demolition and for reuse, clearance of nuclear sites, and clearance for disposal or incineration. This paper outlines the basis for the derivation of these sets of CL which are all based on generic radiological scenarios taking into account all relevant aspects of the materials. The underlying dose criterion is 10 μSv/a individual dose and 1 man·Sv/a collective dose. When deriving sets of CL in Germany care has been taken to be compatible with recommendations of the European Union and the IAEA. It is a common experience that sets of CL which are intended for the same purpose (e.g. general, unconditional clearance) may vary between studies and therefore between countries. This follows directly from differences e.g. in material quantities, boundary conditions, waste management options etc. which may be country specific. German CL are, however, in full agreement with all recommendations issued by the European Commission.

Addressing the Challenge of Polypharmacy

2020 ◽  
Vol 60 (1) ◽  
pp. 661-681 ◽  
Author(s):  
Alpana Mair ◽  
Martin Wilson ◽  
Tobias Dreischulte
Keyword(s):  
Quality Of Life ◽  
European Union ◽  
System Change ◽  
The European Union ◽  
Service Demand ◽  
Global Challenge ◽  
Increased Risk ◽  
Aging Populations ◽  
Detrimental Impact

Polypharmacy describes the concomitant use of multiple medicines and represents a growing global challenge attributable to aging populations with an increasing prevalence of multimorbidity. Polypharmacy can be appropriate but is problematic when the increased risk of harm from interactions between drugs or between drugs and diseases or the burden of administering and monitoring medicines outweighs plausible benefits. Polypharmacy has a substantial economic impact in service demand and hospitalization as well as a detrimental impact on patients’ quality of life. Apart from causing avoidable harm, polypharmacy can also lead to therapeutic failure, with up to 50% of patients who take four or more medications not taking them as prescribed. Guidance is needed to support patients and clinicians in defining and achieving realistic goals of drug treatment, and system change is necessary to aid implementation. This article outlines lessons from two programs that aim to address these challenges: the Scottish polypharmacy guidance on realistic prescribing and the European Union SIMPATHY project.

scholarly journals Osteoporosis in the European Union: a compendium of country-specific reports

2013 ◽  
Vol 8 (1-2) ◽  
Author(s):  
A. Svedbom ◽  
◽  
E. Hernlund ◽  
M. Ivergård ◽  
J. Compston ◽  
...  
Keyword(s):  
European Union ◽  
The European Union ◽  
Country Specific

Comparison of Brain Morphology in Alzheimer’s Dementia in the General Population and Demented Subjects with Down’s Syndrome

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
D. Mullins ◽  
E. Daly ◽  
A. Simmons ◽  
P. Johnston ◽  
K. Murphy ◽  
...  
Keyword(s):  
General Population ◽  
Entorhinal Cortex ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Alzheimer’S Dementia ◽  
Brain Morphology ◽  
Alzheimer's Dementia ◽  
Temporal Lobes ◽  
Lateral Ventricles ◽  
Increased Risk

Aim:To compare Magnetic Resonance Imaging (MRI) findings in Alzheimer's dementia (AD) in the general population with Down's syndrome dementia.Background review: AD is characterised by cognitive dysfunction interfering with activities of daily living. Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia. People with Down's syndrome have an increased risk of developing AD. AD pathology initially appears in the entorhinal cortex, followed by the hippocampus and later in the temporal lobes. These areas are critical for memory functioning.Method:Volumetric analysis was performed on MRI brain scans using Measure software. Manual tracing was undertaken for the hippocampus, temporal lobes and lateral ventricles as well as the total brain volume of the cerebral hemispheres and cerebellum. Brain volumes were normalised as a percentage of traced intracranial volumes. Freesurfer software was used to obtain entorhinal cortical thickness measures. Statistical analysis was undertaken using SPSS15.Results:Subjects with AD (n=46), MCI (n=28) and controls (n=39) were compared with Down's syndrome demented subjects (DS+, n=20), non-demented subjects with Down's syndrome (DS-, n=45) and age-matched controls (n=43). Hippocampi, entorhinal cortex and temporal lobes were significantly reduced in AD and DS+ compared to controls. Lateral ventricles were significantly increased in AD and DS+ compared to controls. MCI and DS- produced findings between those of dementia and controls.Conclusions:Critical memory regions atrophy in dementia corresponding to decreased cognitive functioning. DS+ morphology is comparable to AD in the general population but the atrophy is less pronounced.

Besteuerungsprinzipien und effektive Unternehmenssteuerbelastungen in der Europäischen Union: Regelt sich die EU-weite Steuerharmonisierung von selbst?

2011 ◽  
Vol 12 (1) ◽  
pp. 47-71 ◽  
Author(s):  
Christina Elschner ◽  
Jost H. Heckemeyer ◽  
Christoph Spengel
Keyword(s):  
European Union ◽  
Investment Decisions ◽  
Tax Rates ◽  
Eu Law ◽  
The European Union ◽  
Corporate Tax ◽  
Cross Border ◽  
Tax Regimes ◽  
Country Specific ◽  
The Eu

AbstractEU law demands that the allocation of factors and goods within the European Union shall not be distorted by taxes. Efforts to formally harmonize corporate tax regimes in Europe have, however, stalled in recent years. What is more, the source principle has prevailed over residence based taxation which is seen to be more in line with EU law. Tax induced distortions of cross-border investment decisions are supposed to be the consequence. Based on country-specific effective average tax rates from 1998 to 2009, this article shows that there is, however, non-coordinated convergence of tax burdens within the EU. Thus, distortions of cross-border investment decisions are limited and decreasing even without formal harmonization.

scholarly journals Country-specific determinants of horizontal and vertical intra-industry agri-food trade: the case of Bulgaria and Romania

2013 ◽  
Vol 7 (4-5) ◽  
pp. 69-75
Author(s):  
Attila Jámbor
Keyword(s):  
European Union ◽  
Empirical Studies ◽  
Empirical Literature ◽  
The European Union ◽  
Eu Accession ◽  
Food Trade ◽  
Factor Endowments ◽  
Jel Code ◽  
Economic Size ◽  
Country Specific

The article analyses patterns and country-specific determinants of agri-food trade of Bulgaria and Romania with the European Union. As literature focusing on agricultural aspects of the topic is limited, the paper seeks to contribute to the literature by providing up to date results and suggestions as well as by identifying the determinants of horizontal and vertical intra-industry trade of the Bulgaria and Romania after EU accession. Results suggest that intra-industry agri-food trade is mainly of vertical nature, referring to trade of different quality products. Results verify that determinants of horizontal and vertical IIT are similar and suggest that economic size and FDI are positively, while factor endowments and distance are negatively related to both sides of IIT. Results are mainly in line with the majority of empirical literature in the field. JEL code: Empirical Studies of Trade – F14

scholarly journals Down’s syndrome

2019 ◽  
Vol 13 (1) ◽  
pp. 47-52
Author(s):  
Sarah MacLennan
Keyword(s):  
Clinical Features ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Legal Issues ◽  
Chromosome 21 ◽  
Intellectual Impairment ◽  
Nasal Bridge ◽  
Chromosomal Disorders ◽  
Flat Nasal Bridge ◽  
Increased Risk

Down’s syndrome is caused by trisomy of chromosome 21; it is one of the best known chromosomal disorders in humans. It has effects on most body systems, giving rise to a variety of characteristic clinical features including intellectual impairment, short stature, flat face, flat nasal bridge, prominent epicanthic folds, up slanting palpebral fissures and protruding tongue. Down’s syndrome is also associated with an increased risk of other medical conditions. All patients with Down’s syndrome have a degree of intellectual impairment ranging from mild to severe. This article considers the epidemiology, genetics, associated risks, antenatal screening and potential ethico-legal issues relating to the disorder before discussing clinical features, complications and monitoring requirements. Finally, Down’s syndrome management, prognosis, and future diagnostic tests are outlined.

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