scholarly journals European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome

2016 ◽  
Vol Volume 11 ◽  
pp. 1403-1428 ◽  
Author(s):  
Laura WJ Baijens ◽  
Pere Clavé ◽  
Patrick Cras ◽  
Olle Ekberg ◽  
Alexandre Forster ◽  
...  
Dysphagia ◽  
2021 ◽  
Author(s):  
Renée Speyer ◽  
Reinie Cordier ◽  
Daniele Farneti ◽  
Weslania Nascimento ◽  
Walmari Pilz ◽  
...  

AbstractThis White Paper by the European Society for Swallowing Disorders (ESSD) reports on the current state of screening and non-instrumental assessment for dysphagia in adults. An overview is provided on the measures that are available, and how to select screening tools and assessments. Emphasis is placed on different types of screening, patient-reported measures, assessment of anatomy and physiology of the swallowing act, and clinical swallowing evaluation. Many screening and non-instrumental assessments are available for evaluating dysphagia in adults; however, their use may not be warranted due to poor diagnostic performance or lacking robust psychometric properties. This white paper provides recommendations on how to select best evidence-based screening tools and non-instrumental assessments for use in clinical practice targeting different constructs, target populations and respondents, based on criteria for diagnostic performance, psychometric properties (reliability, validity, and responsiveness), and feasibility. In addition, gaps in research that need to be addressed in future studies are discussed. The following recommendations are made: (1) discontinue the use of non-validated dysphagia screening tools and assessments; (2) implement screening using tools that have optimal diagnostic performance in selected populations that are at risk of dysphagia, such as stroke patients, frail older persons, patients with progressive neurological diseases, persons with cerebral palsy, and patients with head and neck cancer; (3) implement measures that demonstrate robust psychometric properties; and (4) provide quality training in dysphagia screening and assessment to all clinicians involved in the care and management of persons with dysphagia.


Hypertension ◽  
2016 ◽  
Vol 67 (5) ◽  
pp. 820-825 ◽  
Author(s):  
Athanase Benetos ◽  
Christopher J. Bulpitt ◽  
Mirko Petrovic ◽  
Andrea Ungar ◽  
Enrico Agabiti Rosei ◽  
...  

Dysphagia ◽  
2017 ◽  
Vol 32 (6) ◽  
pp. 725-733 ◽  
Author(s):  
R. Dziewas ◽  
◽  
L. Baijens ◽  
A. Schindler ◽  
E. Verin ◽  
...  

Author(s):  
F. Amoretti

The term “e-government” became part of the political vocabulary toward the end of the 1990s. Previously, with the onset of new technologies, it found its place in the wider “semantic container,” the information society. To respond to the United States and Japan’s economic challenge, the European Commission drew up a “White Paper on Growth, Competitiveness, and Employment: Challenges and Ways Forward to the 21st Century” (the so-called Delors’ White Paper). The construction of the IS is considered one of the five fundamental priorities of the Union to create a “common information area” based on ICTs and telematic infrastructure. E-government was the key element of significant community programmes (i.e., IDA [Interchange of Data between Administrations] and TEN-TELECOM [from 2002 renamed eTen]). A decisive step toward the development of EU policies for e-government came with the approval, in June 2000, of the Action Plan “eEurope 2002: An Information Society for All.” Guidelines were fixed for greater use of the Internet, and the initiative “Government online: electronic access to public services, [which] aims to ensure that citizens have easy access to essential public data, [...] [and, in order to improve] efficiency in the public sector, will require a re-thinking of internal organisation and of electronic exchanges between institutions” (Council of the European Union & Commission of the European Communities, 2000, p. 22). A few months previously, based on numerous EC documents, the Council of Europe of Lisbon indicated an ambitious objective for the European Union: “to become the most competitive and dynamic economy based on knowledge in the world, capable of achieving sustainable economic growth, creating new and better jobs and more social cohesion.” The so-called “Lisbon strategy” to permit Europe to recover the delay accumulated compared to the U.S., was intended to guide community policies up to 2010. It is in this context, interwoven with different and often conflicting pressures (economic competition and social cohesion, market logics, and the language of rights) that action plans are formulated and policies for e-government implemented in Europe.


2003 ◽  
Vol 31 (3) ◽  
pp. 353-364 ◽  
Author(s):  
Robert Combes ◽  
Jennifer Dandrea ◽  
Michael Balls

In May, 2003, the European Commission published detailed proposals relating to its 2001 White Paper – Strategy for a Future Chemicals Policy. The White Paper described a new registration system called the REACH (Registration, Evaluation and Authorisation of Chemicals) system, for both new and existing chemicals. Subsequently, these detailed proposals were available for an eight-week consultation period for stakeholders to voice their views and concerns. In this paper, we describe our reactions to the Commission's more-detailed proposals. These include the creation of a European Chemicals Agency to implement the REACH system in conjunction with Competent Authorities (CAs) in Member States and the Commission itself. Unfortunately, many of our concerns and suggestions, previously voiced and shared with several other key stakeholders, remain unanswered, but are as relevant as when the White Paper was published. In particular, we are concerned about the lack of a clear and coherent strategy. There is no guidance for registrants on intelligent testing to maximise the use of non-animal approaches to safety testing, based on a combination of factors for estimating exposure levels, rather than mainly on production volumes. We are also concerned about the absence of a clear programme for the development, improvement and validation of new alternative methods, in conjunction with the Commission's own unit, the European Centre for the Validation of Alternative Methods, as well as other organisations with relevant expertise and experience, including FRAME. Finally, we explain why such measures should be introduced, together with clearer guidelines for the respective roles of the Agency, the CAs and the Commission in implementing and harmonising the REACH system at the European Union and Member State levels. A series of recommendations are made, to improve the situation and to improve the risk assessment process.


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