A systematic review of methods to assess intake of fruits and vegetables among healthy European adults and children: a DEDIPAC (DEterminants of DIet and Physical Activity) study

Evidence suggests that health benefits are associated with consuming recommended amounts of fruits and vegetables (F&V), yet standardised assessment methods to measure F&V intake are lacking. The current review aims to identify methods to assess F&V intake among children and adults in pan-European studies and inform the development of the DEDIPAC (DEterminants of DIet and Physical Activity) toolbox of methods suitable for use in future European studies. A literature search was conducted using three electronic databases and by hand-searching reference lists. English-language studies of any design which assessed F&V intake were included in the review. Studies involving two or more European countries were included in the review. Healthy, free-living children or adults. The review identified fifty-one pan-European studies which assessed F&V intake. The FFQ was the most commonly used (n 42), followed by 24 h recall (n 11) and diet records/diet history (n 7). Differences existed between the identified methods; for example, the number of F&V items on the FFQ and whether potatoes/legumes were classified as vegetables. In total, eight validated instruments were identified which assessed F&V intake among adults, adolescents or children. The current review indicates that an agreed classification of F&V is needed in order to standardise intake data more effectively between European countries. Validated methods used in pan-European populations encompassing a range of European regions were identified. These methods should be considered for use by future studies focused on evaluating intake of F&V

Trade Effects of the Europe Agreements

The eastern enlargement of the European Union (EU) brought and will bring full membership to countries whose trade barriers with the EU had to a large extent already been removed under Free Trade Agreements (FTAs) during the 1990s. We employ a theory-based new version of a gravity equation, whose specification allows for an assessment of the impact of the arrangements on extra- and intra-group imports. We find robust evidence that the agreements have substantially increased intra-group trade, in the case of the Czech and Slovak Republic at the expense of the Rest of the World (ROW).Free Trade Agreements; Gravity equation; Central and Eastern Europe; Panel data

Esmaste peavalude levimus Eestis ning internetipõhise lahenduse kohaldatavus peavalude epidemioloogia alases uurimistöös

Väitekirja elektrooniline versioon ei sisalda publikatsiooneEsmased peavalud on heterogeenne grupp haigusi, mille hulka kuuluvad migreen, pingetüüpi peavalu, trigeminaalautonoomsed tsefalalgiad ning muud esmased peavalud. Esmased peavalud põhjustavad olulist elukvaliteedi langust ja mõjutavad rahvatervist ning ühiskonda. Kõikide esmaste peavalude keskmine aastane levimus Euroopas on 53%, migreenil 14,7% ja pingetüüpi peavalul 62,6%. Eesti kohta ei ole esmaste peavalude levimuse andmeid varem avaldatud. Rahvastikupõhised epidemioloogilised uuringud on ressursi- ning ajakulukad. Samas loob praegune kiire digiühiskonna areng eeldused veebipõhistele meetoditele, mis võimaldaksid nende uuringute ressursimahtu vähendada. Antud uurimustöö eesmärgiks oli esmaste peavalude diagnostilise küsimustiku koostamine ning testimine, esmaste peavalude aastase levimuse määramine 20-64 aastaste täiskasvanute seas Eestis ning veebipõhise lahenduse kohaldatavuse hindamine peavalude epidemioloogilises uurimistöös. Tulemused näitavad, et esmaste peavalude aastased levimused Eesti täiskasvanute seas on sarnased teiste Euroopa riikidega, välja arvatud episoodilise pingetüüpi peavalu osas, mille madal levimus antud uuringus on suure tõenäosusega alahinnatud. Seega on esmased peavalud Eestiski oluliseks haigestumise ja elukvaliteedi languse põhjuseks. Veebipõhine peavalualane epidemioloogiline teadustöö tuleb arvesse kui potentsiaalne aja- ja ressursisäästlik meetod riikides, kus internetirakenduste kasutamine on rahvastikus laialt levinud. Selline lähenemine võimaldab koguda suuri uuringuvalimeid suhteliselt lühikese aja jooksul. Lisaks pakuvad IT-lahendused uuritavate tuvastusviise, mis väldivad andmete kontaminatsiooni, ning tööriistu digitaalsete küsimustike näol, mis suudavad erinevaid peavaludiagnoose rahuldavalt eristada. Edasine uurimistöö on vajalik, et leida usaldusväärseid veebipõhise valimi moodustamise ning uuritavate värbamise viise, et saavutada esinduslikke valimeid ja vältida tulemuste kallutatust.Primary headaches are a group of heterogenous disorders that consist of migraine, tension-type headache, trigeminal autonomic cephalagias and other primary headaches. These disorders cause considerable loss of quality of life and have a remarkable socioeconomic impact. The mean 1-year prevalence of all headaches in Europe is 53%, of migraine 14.7% and of tension-type headache 62.6%. The prevalence of primary headaches in Estonia has not been studied before. Traditional epidemiological studies are resource- and time-consuming. However, wide usage of internet in the population creates a possibility for applying web-based methods in headache epidemiological research that can be more resource-saving. The aim of this study was to compile and test a headache diagnostic questionnaire, to determine the 1-year prevalence of primary headaches among 20-64 year olds in Estonia and to evaluate the applicability of web-based surveys in epidemiological studies of primary headaches. The results show that the 1-year prevalences of primary headaches in Estonia are similar to other European countries, except for tension-type headache. The low prevalence of tension-type headache in this study is most probably an underestimation. This implies that primary headaches in Estonia are an important cause of morbidity as well as a prominent socioeconomic burden. It can be concluded, that online headache research may be a time- and resource efficient alternative in IT-developed countries. In addition to obtaining larger study samples in relatively short time periods, the IT solutions can provide participant identification methods that avoid data contamination and are able to distinguish most primary headache disorders sufficiently. However, further research is needed to find more reliable methods of online access and engagement to gain representative samples and overcome the pitfalls of bias and most probably underestimation of headache prevalence in web-based epidemiological research.https://www.ester.ee/record=b537028

A snapshot of the health of young people in Europe

A report prepared for the European Comission Conference on Youth Health, Brussels Belgium, 9-10 July 200

Technological Dynamics and Social Capability: Comparing U.S. States and European Nations

This paper analyzes factors that shape the technological capabilities of individual U.S. states and European countries, which are arguably comparable policy units. The analysis demonstrates convergence in technological capabilities from 2000 to 2007. The results indicate that social capabilities, such as a highly educated labor force, an egalitarian distribution of income, a participatory democracy and prevalence of public safety, condition the growth of technological capability. The analysis also considers other aspects of territorial dynamics, such as the possible effects of spatial agglomeration, urbanization economies, and differences in industrial specialization and knowledge spillovers from neighboring regions.innovation; technological capabilities; European Union; United States Disclaimer: All

European Transition at Twenty

This study gauges the status of transition in the formerly centrally planned economies of Eastern Europe and Central Asia, using a broad approach that compares countries with respect to their business environment, competition, and managerial practices; and assesses transition progress at the level of 13 economic sectors. The largest transition gaps remain in Central Asia and some Eastern European and Western Balkans countries. However, significant reform needs also remain in some Central European and Baltic countries, particularly in energy efficiency, transport, and in the financial sector where regulatory regimes require strengthening and local capital markets need to be developed.transition, economic reform, managerial practices, competition, business environment

Global patterns in wolf (Canis lupus) ecology: Implications for management = Patrons globals en l'ecologia del llop: Implicacions en la gestió

[eng] Environmental authorities, conservation professionals, and several other social sectors frequently demand scientifically sound information to inform policy and decision-making processes. Beyond national or subnational conservation laws, biodiversity conservation increasingly relies on international agreements and commitments, through which sovereign nations commit to share part of their duties and responsibilities in conservation issues. In this pyramidal structure of multi-governance layers, the use of the best available evidence is of paramount importance to effectively adapt general statements contained in general laws or regulations into specific contexts. Using wolves (Canis lupus) as case study, this thesis explores the interface between ecology and policy-making in wildlife conservation and management at different spatial and governance scales. The thesis combines empirical evidence, focused on wolf breeding site attributes and livestock depredations by wolves, literature reviews and in-deep analyses of conservation and management instruments in order to critically assess how evidence is used to develop site-specific management actions, and the way forward to improve policy implementations and effectiveness. The thesis provides an illustrative example of how unveiling general ecological patterns and sources of variation from empirical datasets can provide valuable information to policy decision-makers. In particular, Chapter 1 analyses global patterns in breeding site selection by wolves regarding their vulnerability to humans. Remarkable findings from this chapter are the relationship between the strength of the response (selection of refuge vegetation and avoidance of exposed areas) and the human population density as a surrogate of human pressure. In addition, continental differences are described, being the selection towards more secluded and remote areas stronger in Eurasia than in North America, which denote differences in coexistence history. By identifying global patterns and context-dependent sources of variability on this issue, Chapter 2 explores whether current mandates to protect wolf breeding sites at the European level are translated effectively into domestic management instruments. The need of a more accurate transposition from general commitments to taxon-specific management instruments at the local scale is underlined. Chapter 3 explores the widely assumed positive relationship between the number of wolves and the number of livestock attacks, and shows that the history of coexistence can explain remarkable differences between territories, undermining the general assumption that the increase in wolf population size will translate into higher human-wolf conflict levels. Generally, traditional husbandry techniques oriented to minimize wolf predation on livestock seem to persist in areas where wolves have not been extirpated during the second half of the 20th century and could explain the disassociation of attacks on livestock from wolf abundance in these areas. Chapter 4 goes further with the impact of wolves on livestock conducting a critical test of the frequently used assumption of the existence of negative correlation between wild prey abundance and the number of livestock depredations. We test this assumption with field observations in a particular context from northwest Spain. This thesis calls the attention on the importance of local knowledge and contexts when implementing management and conservation interventions, in order to avoid a lack of effectiveness or undesired outcomes when local management actions are grounded on general assumptions. Nonetheless, it also demonstrates that when this site-specific knowledge is not available, compiling data from multiple contexts to extract general patterns can also be useful to assist decision-making.[cat] Les autoritats ambientals, els professionals de la conservació i altres sectors socials, demanen freqüentment informació científica fiable per a l'elaboració de polítiques i la presa de decisions. Més enllà de la normativa ambiental a nivell dels estats o regions, la conservació de la biodiversitat recau cada cop més en acords i compromisos internacionals, a través dels quals les sobiranies acorden repartir-se part dels seus deures i responsabilitats en matèria de conservació. En aquest sistema piramidal de governança amb diversos nivells, l'ús de la millor evidència a l'abast és fonamental a l'hora d'adaptar els mandats generals continguts en lleis o regulacions als contextos específics. A partir del llop (Canis lupus) com a model d'estudi, aquesta tesi explora la interfície entre ecologia i la definició de polítiques en matèria de conservació i gestió de la natura a diferents escales espacials i de governança. La tesi combina l'evidència empírica focalitzada en les característiques dels llocs de reproducció dels llops i els danys a la ramaderia, la revisió de literatura científica i l'anàlisi dels instruments en què es basa la gestió i conservació del llop, amb la finalitat de fer una revisió crítica de com l'evidència fonamenta l'actual gestió de l'espècie en contextos específics i la manera en què la implementació i eficàcia d'aquestes polítiques es podria millorar. Aquesta tesi representa un exemple de com el fet d'explorar patrons ecològics generals i la seva variabilitat a partir de dades empíriques pot proporcionar informació valuosa als gestors implicats. Concretament, el Capítol 1 analitza els patrons globals en la selecció dels llocs de reproducció dels llops en relació a la seva vulnerabilitat enfront els humans. A partir de la identificació de patrons globals i fonts de variabilitat en aquest àmbit, el Capítol 2 es planteja si els mandats de protegir els llocs de reproducció dels llops, existents a nivell europeu, son transferits de manera efectiva als instruments de gestió a escala local. El capítol 3 explora l'estesa assumpció d'una relació positiva entre el nombre de llops i el nombre de danys al bestiar, i mostra com la història de la coexistència pot explicar diferències destacables entre territoris. El Capítol 4 va més enllà en l'impacte dels llops sobre el bestiar domèstic i fa una anàlisi crítica d'una altra assumpció freqüentment utilitzada, que suggereix una correlació negativa entre l'abundància de preses salvatges i els danys a la ramaderia. Finalment, aquesta tesi destaca la importància del coneixement dels contextos locals a l'hora d'implementar intervencions de conservació i gestió per tal d'evitar una falta d'efectivitat o efectes indesitjats quan la gestió a nivell local es basa en assumpcions generals

Mapping the Global Muslim Population: A Report on the Size and Distribution of the World's Muslim Population

Highlights findings from a demographic study of the estimated Muslim population worldwide. Presents data and maps on the geographic distribution of Muslims by country and territory, region, subregion, sect, and majority status

E-Government interoperability frameworks: a worldwide inventory

An e-government Interoperability Framework (IF) is a document or group of documents that specify a set of common elements such as vocabularies, concepts, principles, policies, guidelines, recommendations, standards, and practices for agencies that wish to work together, towards the joint delivery of public services. IFs are seen by governments as promising instruments to boost the interoperability of their services and systems. Henceforth, many countries have created and published their IFs along the last years. To the best of our knowledge no study has been carried out so far in order to identify the comprehensive list of countries that already have an IF. We argue that the existence of such a list would be very useful and valuable for both practitioners and researchers communities. Hence, this study addresses the question which is the worldwide comprehensive list of countries that currently have an e-government Interoperability Framework? To answer this question a worldwide survey that combined a web survey and a web questionnaire was conducted. The aim of this paper is to describe the effort and procedure done in order to conduct the worldwide survey and to present the results achieved with it

Kolorektaalvähi ravi ja tulemite hindamine ning nende parandamise võimalused Eestis

Väitekirja elektrooniline versioon ei sisalda publikatsiooneKolorektaalvähk on üks sagedamaid vähihaigestumuse ja -surma põhjuseid maailmas. Sõeluuringuga on võimalik vähendada kolorektaalvähi haigestumust ja suremust. Töö eesmärk on hinnata kolorektaalvähi haigestumust, ravikvaliteeti ja elulemust Eestis ning leida võimalusi tulemuste parandamiseks. Eesti Vähiregistrist saadud andmete põhjal analüüsiti pikaajalisi haigestumuse ja elulemuse trende. Diagnostika ja ravi muutuste hindamiseks kasutati kolorektaalvähi patsientide 1997. ja 2011. aasta kohortide andmeid. Viidi läbi randomiseeritud uuring, et hinnata operatsioonipreparaatide intraarteriaalse metüleensinisega värvimise mõju lümfisõlmede leidmisele. Käär- ja pärasoolevähi haigestumus Eestis suurenes uuringuperioodil. Viimaste aastate haigestumuse tõus vanuserühmas 60–69 ja I staadiumi osakaalu tõus viitavad sõeluuringu mõjule. Elulemus paranes oluliselt, kuid jäi siiski ligikaudu 10% võrra madalamaks võrreldes Põhjamaadega. Haigestumuse ja elulemuse trendid erinesid alapaikme, soo, vanuse ja staadiumite lõikes. Oluliselt madalam elulemus ilmnes III staadiumi maksanurga vähi korral, mille põhjuste selgitamiseks on vajalikud täiendavad uuringud. Diagnostika ja multimodaalne ravi on Eestis oluliselt paranenud, kuid tuvastati siiski mitmed probleemkohad. Jätkuvalt on probleemiks hilinenud diagnoosimine, metastaatilise haiguse osakaal püsib kõrge ja tõusnud on erakorraliste operatsioonide hulk. Metüleensinisega värvimine parandab oluliselt staadiumi määramise täpsust, võimaldades seeläbi loobuda osadel patsientidel ebavajalikust adjuvantsest keemiaravist. Kolorektaalvähi haigestumuse ja suremuse vähendamiseks tuleb võidelda riskiteguritega ja tõhustada sõeluuringut läbi suurema hõlmatuse ja kvaliteedi tagamise. Tuleb teha pingutusi varase avastamise, õigeaegse diagnoosimise ja ravi tagamiseks kõigile patsientidele ja ravikvaliteedi pidevaks jälgimiseks.Colorectal cancer is one of the leading causes of cancer incidence and mortality with increasing occurrence in the world. Organised screening programs can effectively reduce incidence and mortality. The general aim of this thesis was to evaluate colorectal cancer incidence, quality of care and survival in Estonia and find possibilities for improvement. Estonian Cancer Registry provided data for the analysis of long-term incidence and survival trends. Changes in diagnosis and treatment were examined using data on two patient cohorts diagnosed in 1997 and 2011. A randomised controlled trial was conducted to assess the effect of intra-arterial methylene blue staining of resected colorectal cancer specimens on the accuracy of lymph node staging. Colorectal cancer incidence increased steadily over the study period. A recent surge in age group 60–69 along with the rise of stage I tumours suggest an effect of the introduction of screening. Survival improved significantly but remained considerably lower than in Northern Europe. Substantial heterogeneity was observed across subsites, sex, age and stage groups. We observed a distinct survival disadvantage among stage III hepatic flexure cancer patients, further research is required to identify the underlying reasons. Major advancements were seen in diagnosis, staging and treatment, but several areas of further improvement were identified. Diagnostic delay is a major obstacle, the proportion of metastatic disease remained high and an increase in emergency surgery was seen. By significantly improved staging accuracy, methylene blue staining could avoid unnecessary adjuvant chemotherapy in a number of patients. To reduce CRC incidence and mortality, it is necessary to tackle risk factors and increase screening effectiveness through better participation and quality assurance. Efforts are necessary to ensure early detection, timely diagnosis and treatment for all patients and continuous monitoring of the quality of care.https://www.ester.ee/record=b550708