RAPID RISK ASSESSMENT Zika virus infection outbreak,

This is the first documented outbreak of Zika virus (ZIKAV) infection in French Polynesia and New Caledonia. During the course of the ZIKAV outbreak, neurological and auto-immune complications have been reported in a context of concurrent circulation of two dengue serotypes (dengue 1 and 3) since February 2013. Vigilance must be enhanced towards imported cases of ZIKAV infection in the EU Member States and EU overseas countries and territories and outermost regions, in particular where effective vectors are present; early detection of cases is essential to reduce the risk of autochthonous transmission. Clinicians and travel medicine clinics should be aware of the situation in the Pacific islands and include ZIKAV infection in their differential diagnosis. An isolated positive result for dengue IgM antibodies among travellers returning from areas affected by Zika should prompt a possible investigation for another flavivirus aetiology. The potential neurological and auto-immune complications might require specific healthcare capabilities and treatment (ICU) which need to be taken into account in an insular context facing a large-scale Zika outbreak. As an emerging pathogen, the laboratory capacity to confirm suspected Zika cases should be strengthened in the region as well as in Europe to differentiate ZIKAV infections from other arboviral dengue-lik

European security in the 1990s and beyond : the implications of the accession of Cyprus and Malta to the European Union

For the last decade, the dramatic events in eastern and central Europe have (rightly) dominated the security debate in Europe and, indeed, the wider world. One of the consequences of this has been that the traditional neglect of the Mediterranean region has been compounded. However, there are now signs-notably the recent Barcelona conference at which the European Union's Mediterranean policy was relaunched and extended (to incorporate the grand design of a Mediterranean free trade area) - that the Mediterranean is, at last, receiving some of the attention it deserves and justifies.peer-reviewe

Cross-national variations in reported discrimination among people treated for major depression worldwide : the ASPEN/INDIGO international study

No study has so far explored differences in discrimination reported by people with major depressive disorder (MDD) across countries and cultures. To (a) compare reported discrimination across different countries, and (b) explore the relative weight of individual and contextual factors in explaining levels of reported discrimination in people with MDD. Cross-sectional multisite international survey (34 countries worldwide) of 1082 people with MDD. Experienced and anticipated discrimination were assessed by the Discrimination and Stigma Scale (DISC). Countries were classified according to their rating on the Human Development Index (HDI). Multilevel negative binomial and Poisson models were used. People living in ‘very high HDI’ countries reported higher discrimination than those in ‘medium/low HDI’ countries. Variation in reported discrimination across countries was only partially explained by individual-level variables. The contribution of country-level variables was significant for anticipated discrimination only. Contextual factors play an important role in anticipated discrimination. Country-specific interventions should be implemented to prevent discrimination towards people with MDD

How to evaluate sexual health in cancer patients:Development of the EORTC sexual health questionnaire for cancer patients

Background: The aim of the study is to describe the development of a comprehensive European Organisation for Research and Treatment of Cancer (EORTC) questionnaire to assess sexual health of female and male cancer patients and for cancer survivors. Methods: According to the EORTC guidelines, the development of an EORTC sexual health questionnaire is typically organised in four phases. The first phases comprise a literature search following interviews with patient and health care professionals (HCPs) (phase 1) and the operationalization into items (phase 2). The translation process is formally conducted according to the EORTC QLG Translation guidelines with a rigorous forward-backward procedure supported by native speakers. Results: Studies on sexuality in oncology patients which were identified by a literature search predominantly focused on issues of activity, experiences of sexual dysfunction, and satisfaction with sexual functioning. The literature review identified themes beyond these aspects. In total 53 potentially relevant issues were presented to 107 patients and 83 HCPs, different evaluations were found. Conclusions: A questionnaire that includes physical, psychological, and social aspects of sexuality of cancer survivors will be needed. Pre-testing and validation of the questionnaire will be done in future (phases 3 and 4). Divergent ratings of patients and professionals should be further investigated. Keywords: Cancer; sexual health; European Organisation for Research and Treatment of Cancer (EORTC) sexual health questionnair