Recent decrease in the prevalence of congenital heart defects in europe.

OBJECTIVES: To examine trends in the prevalence of congenital heart defects (CHDs) in Europe and to compare these trends with the recent decrease in the prevalence of CHDs in Canada (Quebec) that was attributed to the policy of mandatory folic acid fortification. STUDY DESIGN: We used data for the period 1990-2007 for 47 508 cases of CHD not associated with a chromosomal anomaly from 29 population-based European Surveillance of Congenital Anomalies registries in 16 countries covering 7.3 million births. We estimated trends for all CHDs combined and separately for 3 severity groups using random-effects Poisson regression models with splines. RESULTS: We found that the total prevalence of CHDs increased during the 1990s and the early 2000s until 2004 and decreased thereafter. We found essentially no trend in total prevalence of the most severe group (group I), whereas the prevalence of severity group II increased until about 2000 and decreased thereafter. Trends for severity group III (the most prevalent group) paralleled those for all CHDs combined. CONCLUSIONS: The prevalence of CHDs decreased in recent years in Europe in the absence of a policy for mandatory folic acid fortification. One possible explanation for this decrease may be an as-yet-undocumented increase in folic acid intake of women in Europe following recommendations for folic acid supplementation and/or voluntary fortification. However, alternative hypotheses, including reductions in risk factors of CHDs (eg, maternal smoking) and improved management of maternal chronic health conditions (eg, diabetes), must also be considered for explaining the observed decrease in the prevalence of CHDs in Europe or elsewhere.

Rakennusten kosteus ja home : yleisyys, syyt ja toteaminen

Aino Nevalainen ja Anne Hyvärinen

Long-range transport of Saharan dust to northern Europe: The 11-16 October 2001 outbreak observed with EARLINET

The spread of mineral particles over southwestern, western, and central Europeresulting from a strong Saharan dust outbreak in October 2001 was observed at10 stations of the European Aerosol Research Lidar Network (EARLINET). For the firsttime, an optically dense desert dust plume over Europe was characterized coherentlywith high vertical resolution on a continental scale. The main layer was located abovethe boundary layer (above 1-km height above sea level (asl)) up to 3–5-km height, andtraces of dust particles reached heights of 7–8 km. The particle optical depth typicallyranged from 0.1 to 0.5 above 1-km height asl at the wavelength of 532 nm, andmaximum values close to 0.8 were found over northern Germany. The lidar observationsare in qualitative agreement with values of optical depth derived from Total OzoneMapping Spectrometer (TOMS) data. Ten-day backward trajectories clearly indicated theSahara as the source region of the particles and revealed that the dust layer observed,e.g., over Belsk, Poland, crossed the EARLINET site Aberystwyth, UK, and southernScandinavia 24–48 hours before. Lidar-derived particle depolarization ratios,backscatter- and extinction-related A ° ngstro¨m exponents, and extinction-to-backscatterratios mainly ranged from 15 to 25%, 0.5 to 0.5, and 40–80 sr, respectively, within thelofted dust plumes. A few atmospheric model calculations are presented showing the dustconcentration over Europe. The simulations were found to be consistent with thenetwork observations.

Europe and the Petersberg Tasks – Nation-State behavior through the prism of Strategic Culture

Les missions Petersberg són l'operatiu militar més ambiciós organitzat per la Unió Europea en el desenvolupament de la CSDP, Política Europea de Seguretat i Defensa. Amb l'objectiu d'aconseguir una organització efectiva y funcional d'aquestes missions, és desitjable que les cultures estratègiques dels diferents Estats membres siguin, en gran mesura, compatibles en benefici d'una cultura estratègica europea amb directrius clares. Aquest estudi compara les cultures estratègiques d'Alemanya, el Regne Unit i França en referència al seu nivell de compatibilitat contrastant-les amb dos casos recents, exemples paradigmàtics de cultures estratègiques integrals. D'aquesta manera, pretenem descriure les circumstàncies en què es desenvolupen les missions Petersberg.

Frequency and determinants of urgent requests to home care agencies for community-dwelling elderly.

We analyzed a one-year case series and performed a longitudinal (4 month) cohort analysis of urgent requests made to home care agencies by and for their > or = 65 years old clients in order to estimate the frequency of unscheduled services delivered by home care agencies and to identify risk factors. All 40 home care agencies located in a Swiss region were included in the study and we registered 3,816 urgent requests (75/1,000 > or = 65 years residents per year). Among home care users, the presence of a urinary catheter, incontinence and the need for assistance in bathing were predictors of unscheduled services. Resources should be planned in order to help home care teams to handle unexpected, disruptive clusters of urgent requests that may compromise their scheduled activities.

Iowa Veterans Home, FY 2007

These Facts sheets have been developed to provide a multitude of information about executive branch agencies/departments on a single sheet of paper. The Facts provides general information, contact information, workforce data, leave & benefits information, and affirmative action data. This is the most recent update of information for the fiscal year 2007.

Iowa Veterans Home, FY 2008

These Facts sheets have been developed to provide a multitude of information about executive branch agencies/departments on a single sheet of paper. The Facts provides general information, contact information, workforce data, leave & benefits information, and affirmative action data. This is the most recent update of information for the fiscal year 2007.

Atrioventricular septal defects among infants in Europe: a population-based study of prevalence, associated anomalies, and survival.

OBJECTIVE: To describe the epidemiology of chromosomal and non-chromosomal cases of atrioventricular septal defects in Europe. METHODS: Data were obtained from EUROCAT, a European network of population-based registries collecting data on congenital anomalies. Data from 13 registries for the period 2000-2008 were included. RESULTS: There was a total of 993 cases of atrioventricular septal defects, with a total prevalence of 5.3 per 10,000 births (95% confidence interval 4.1 to 6.5). Of the total cases, 250 were isolated cardiac lesions, 583 were chromosomal cases, 79 had multiple anomalies, 58 had heterotaxia sequence, and 23 had a monogenic syndrome. The total prevalence of chromosomal cases was 3.1 per 10,000 (95% confidence interval 1.9 to 4.3), with a large variation between registers. Of the 993 cases, 639 cases were live births, 45 were stillbirths, and 309 were terminations of pregnancy owing to foetal anomaly. Among the groups, additional associated cardiac anomalies were most frequent in heterotaxia cases (38%) and least frequent in chromosomal cases (8%). Coarctation of the aorta was the most common associated cardiac defect. The 1-week survival rate for live births was 94%. CONCLUSION: Of all cases, three-quarters were associated with other anomalies, both chromosomal and non-chromosomal. For infants with atrioventricular septal defects and no chromosomal anomalies, cardiac defects were often more complex compared with infants with atrioventricular septal defects and a chromosomal anomaly. Clinical outcomes for atrioventricular septal defects varied between regions. The proportion of termination of pregnancy for foetal anomaly was higher for cases with multiple anomalies, chromosomal anomalies, and heterotaxia sequence.