The devil is in the detail:tobacco industry political influence in the Dutch implementation of the 2001 EU Tobacco Products Directive

Introduction - The Dutch implementation of the black border provision in the 2001 European Union Tobacco Products Directive (TPD) is studied to examine the implications of tobacco industry involvement in the implementation phase of the policy process. Methods - A qualitative analysis was conducted of Dutch government documents obtained through Freedom of Information Act requests, triangulated with in-depth interviews with key informants and secondary data sources (publicly available government documents, scientific literature, and news articles). Results - Tobacco manufacturers’ associations were given the opportunity to set implementation specifications via a fast-track deal with the government. The offer of early implementation of the labelling section of the TPD was used as political leverage by the industry, and underpinned by threats of litigation and arguments highlighting the risks of additional public costs and the benefits to the government of expediency and speed. Ultimately, the government agreed to the industry's interpretation, against the advice of the European Commission. Conclusions - The findings highlight the policy risks associated with corporate actors’ ability to use interactions over technical product specifications to influence the implementation of health policy and illustrate the difficulties in limiting industry interference in accordance with Article 5.3 of the Framework Convention on Tobacco Control (FCTC). The implementation phase is particularly vulnerable to industry influence, where negotiation with industry actors may be unavoidable and the practical implications of relatively technical considerations are not always apparent to policymakers. During the implementation of the new TPD 2014/40/EU, government officials are advised to take a proactive role in stipulating technical specifications

Physiotherapeutic interventions in multiple sclerosis across Europe: Regions and other factors that matter.

BACKGROUND: A wide variety of interventions exists in physical therapy (PT), but knowledge about their use across different geographical regions is limited. This study investigated the use of PT interventions in people with multiple sclerosis (MS) across Europe. It aimed to determine whether regions differ in applying interventions, and explore whether factors other than regions play a role in their use. METHODS: In an online cross-sectional survey, 212 respondents from 115 European workplaces providing PT services to people with MS representing 26 countries (four European regions) participated. Cluster analysis, Pearson Chi-squared test and a Poisson regression model were used to analyze the data. RESULTS: Thirteen of 45 listed PT interventions were used by more than 75% of centers, while nine interventions were used by less than 25%. For 12 interventions, regions differed markedly in their use. Cluster analysis of centers identified four clusters similar in their intervention use. Cluster assignment did not fully align with regions. While center region was important, center size, number and gender of physical therapists working in the center, and time since qualification also played a role. Cluster analysis exploring the use of the interventions provided the basis for a categorization of PT interventions in line with their primary focus: 1. Physical activity (fitness/endurance/resistance) training; 2. Neuroproprioceptive "facilitation/inhibition"; 3. Motor/skill acquisition (individualized therapy led); 4. Technology based interventions. CONCLUSIONS: To our knowledge this is the first study that has explored this topic in MS. The results broaden our understanding of the different PT interventions used in MS, as well as the context of their use

ELIMINATION OF IRREGULARITIES AND DEFECTS ON STEEL SURFACES THROUGH ELECTRO SPARK SURFACE MODIFICATION WITH ALUMINUM ALLOYS

The surface roughness of the parts has a significant influence on their performance properties and it is crucial for the friction force and wear of the bodies. Therefore, in practice it is often necessary to perform finishing treatment to reduce the macro, micro and meso- roughnesses - grinding, honing, lapping, polishing and more. In this study are examined the possibilities of reducing the roughness and the traces of the previous machining of steel surfaces by electro-spark deposition (ESD) with low-melting aluminium alloys. The roughness of the steel surfaces obtained after different milling modes after subsequent electrospark coating was investigated. Dense and uniform coatings with different surface microgeometry are obtained, which to a different extent erase the traces of the preceding processing. The examination of tribological characteristics showed a significant increase in the wear resistance of the coated surfaces. The process parameters and materials for ESD at which coated surfaces have simultaneously the lowest roughness and the highest wear resistance have been determined and optimized

The approach of physiatrists to low back pain across Europe

Low back pain (LBP) is the most common type of musculoskeletal pain, thus it is one of the most commonly encountered conditions in Physical and Rehabilitation Medicine. The physicians who are primarily responsible for the nonsurgical management of LBP are physiatrists

Multiwavelength behaviour of the blazar 3C 279: decade-long study from gamma-ray to radio

We report the results of decade-long (2008-2018) gamma-ray to 1 GHz radio monitoring of the blazar 3C 279, including GASP/WEBT, Fermi and Swift data, as well as polarimetric and spectroscopic data. The X-ray and gamma-ray light curves correlate well, with no delay greater than or similar to 3 h, implying general cospatiality of the emission regions. The gamma-ray optical flux flux relation changes with activity state, ranging from a linear to a more complex dependence. The behaviour of the Stokes parameters at optical and radio wavelengths, including 43 GHz Very Long Baseline Array images, supports either a predominantly helical magnetic field or motion of the radiating plasma along a spiral path. Apparent speeds of emission knots range from 10 to 37c, with the highest values requiring bulk Lorentz factors close to those needed to explain gamma-ray variability on very short time-scales, The Mg II emission line flux in the 'blue' and 'red' wings correlates with the optical synchrotron conlinuum flux density, possibly providing a variable source of seed photons for inverse Compton scattering. in the radio bands, we find progressive delays of the most prominent light-curve maxima with decreasing frequency, as expected from the frequency dependence of the tau = 1 surface of synchrotron self-absorption. The global maximum in the 86 GHz light. curve becomes less prominent at lower frequencies, while a local maximum, appearing in 2014, strengthens toward decreasing frequencies, becoming pronounced at similar to 5 GHz, These tendencies suggest. different Doppler boosting of stratified radio-emitting zones in the jet