Treatment of cannabis-related disorders in Europe

This publication is part of a set of statistical articles based on the Eurostat document “Being young in Europe today. It reviews the interventions used in the treatment of cannabis disorders and maps out the geography of cannabis treatment in Europe.

To download the publication, click here on www.emcdda.europa.eu

For more information about the Eurostat document, click here on http://ec.europa.eu

WHO helps reduce the marketing to children of foods

Unhealthy diets are a leading factor affecting health and well-being in every European country, with rising overweight and obesity among children of particular concern as it affects up to 27% of 13-year-olds and 33% of 11-year-olds. The leading categories of advertised foods are soft drinks, sweetened breakfast cereals, biscuits, confectionery, snack foods, ready meals and fast food. Brand recognition starts in early childhood and children who recognize multiple brands by the age of 4 years are more likely to eat unhealthily and be overweight.

Research has demonstrated that overweight children in particular respond to the presence of branded food packaging by increasing their consumption. Marketing of foods high in energy, fats, sugars or salt has a documented harmful impact on children as it promotes the development of unhealthy food preferences and diets, and childhood obesity, thus contributing to the later development of diet-related non-communicable diseases. Yet across Europe, children are still regularly exposed to marketing that promotes foods and drinks high in energy, saturated fats, trans-fatty acids, free sugars or salt.

Despite progress in some countries, it can be difficult for governments to identify foods whose marketing should be restricted, so WHO has developed a nutrient profile model for countries to adapt and use to classify foods according to their nutritional composition. Policy-makers across the Region will be able to use this tool to determine whether or not a food product should be marketed to children. The WHO model is largely based on the Danish and Norwegian models, which are used to restrict food marketing to children and countries can either use the model as it is, or adapt it to their own cultural circumstances. It can be used in two ways:

  • to identify foods not to be marketed to children
  • to monitor the extent and nature of food marketing.

For more information on the WHO nutrient profile model, click here   on www.euro.who.int

For more information on the European Food and Nutrition Action Plan 2015-2020, click here on www.euro.who.int

WHO’s rundown on e-cigarettes

E-cigarettes are designed to deliver nicotine or other substances to a user as an aerosol rather than burning tobacco. The liquid contains four main ingredients: propylene glycol and/or glycerine as a base for producing the aerosol, flavours and optional nicotine. E-cigarettes contain and deliver varying levels of nicotine, some of which can be similar to levels in cigarettes.

About 500 e-cigarette brands are available today, but only a few have been analysed. Evidence  shows that e-cigarettes’ aerosol usually contains cancer-causing compounds, but at levels 1–2 orders of magnitude lower than those in tobacco smoke. E-cigarettes are therefore likely to be less toxic than conventional cigarettes but the levels of carcinogenic agents in some of the analysed brands are as high as those in the smoke produced by some cigarettes.

According to WHO’s 2014 report, “Electronic nicotine delivery systems”, the main health risks from e-cigarettes come from inhaling the nicotine and other toxic emissions and from overdosing by ingestion or through skin contact. Users fill e-cigarettes’ containers themselves so they, not the manufacturers, set the levels of nicotine. Nicotine poisoning can result from the liquid’s accidentally coming into contact with users’ skin or ingestion by children. The United States and the United Kingdom have already seen a tremendous increase in reported nicotine poisoning, often involving children.

Nevertheless, the reduced exposure to toxicants of well regulated e-cigarettes, used by established adult smokers as a complete substitution for cigarettes, is likely to be less toxic than conventional cigarettes or other combusted tobacco products. The amount of risk reduction, however, is unknown. E-cigarettes may carry a risk of addiction to nicotine and tobacco products among young people and non-smokers. However, they are likely to be less toxic than cigarettes for adult smokers if product content is well regulated and if the smokers use them as a complete substitution for cigarettes.

The inhalation of nicotine by nonsmokers, adolescents and pregnant women not only leads to addiction but has also been linked to some cardiovascular problems in adults. In addition, fetal and adolescent nicotine exposure can have long-term consequences for brain development. As young people account for a growing proportion of e-cigarette users, anti-tobacco experts are concerned that e-cigarette use can serve as a gateway for them to nicotine addiction and ultimately smoking. The literature shows that experimentation with e-cigarettes among adolescents doubled in 2008–2012. One of the presumed reasons for this can be the great variety of flavours of e-cigarettes (up to 8000 are available), including flavours like those of fruit, candy and alcoholic drinks. These could entice young people to experiment with e-cigarettes and then become addicted to nicotine.

For all these reasons, WHO can neither dismiss nor accept the use of e-cigarettes globally without further evidence, and regulation is necessary in the meantime both to protect the public from any potential ill effects and to ensure that these products do not contribute to the tobacco epidemic.

For more information on the WHO report, click here      on www.who.int

The life-long impact of breastfeeding

Almost 3500 participants in Brazil were followed up from birth in 1982 until they were around 30 years old to try and assess whether there were long-term differences between those who had been breastfed and those who had not. The variables that were studied were intelligence—as assessed by a widely used intelligence test (Wechsler Adult Intelligence Scale, 3rd version)—educational attainment, and income.

The study contributed important knowledge about three issues related to the effects of breastfeeding on cognitive development. Firstly, the study’s findings showed the effects of breastfeeding in a cultural and economic setting without strong social patterning of breastfeeding; second, it investigated long-term effects of breastfeeding during a substantial part of the full lifespan; and third, it described life course consequences of breastfeeding by incorporating socially important outcomes, such as education and income.

To read more, click here on www.thelancet.com

Rare diseases

A disease or disorder is defined as rare in the EU when it affects less than five in every 10,000 citizens. However, because there are so many different rare diseases – between 6,000 and 8,000 – between 30 and 40 million people in the EU, many of whom are children, suffer from rare diseases.

Most rare diseases have genetic origins while others are the result of infections, allergies and environmental causes. They are usually chronically debilitating or even life-threatening. The fragmentation of knowledge about rare diseases and the small numbers of patients affected by a single disease makes it indispensable to work across borders. One of the greatest challenges for sufferers of rare diseases and their families is getting a timely and correct diagnosis. This is an essential first step before treatment options can be explored and the European Commission has developed a number of initiatives to help member states.

One of these is the ORPHANET project which has developed a database listing the descriptions of almost 6000 rare diseases and has become the number one online source of information on rare diseases worldwide. This tool is an invaluable resource for clinicians, health professionals and patients seeking a diagnosis. It is also establishing European Reference Networks (ERNs) to facilitate cooperation between Member States in the development of diagnosis and treatment capacity to provide highly specialised healthcare for rare or low prevalence complex diseases or conditions.

As a result, patients will have easier access to expertise on rare diseases beyond their national border. There will also be national contact points where patients can receive information on where to find the most appropriate treatment for their disease, anywhere across the EU.

For more information about the EU’s policies on rare diseases, click here on http://ec.europa.eu

Europe unites against online child sexual abuse

The international problem of online child sexual abuse needs an international solution and the European Parliament is calling for united efforts to investigate online child sexual abuse, prosecute offenders, protect child victims and remove illegal online content.

More than 80% of the victims are under 10 years old and Parliament’s call for action states that:

  • any illicit content must be promptly removed and reported to law enforcement authorities, with the ICT industry, internet service providers and internet host providers ensuring fast and efficient removal
  • Europol and national law enforcement authorities should be given the necessary funds, human resources, investigative powers and technical capabilities to “seriously and effectively pursue, investigate and prosecute the offenders”
  • new high-tech capabilities should be developed to meet the challenges of analysing vast amounts of child abuse imagery, including material hidden on the “dark web”
  • the online personal data of children must be protected, and they should be informed in an easy and child-friendly way of the risks and consequences of using their data online
  • awareness-raising campaigns on responsible behaviour in the social media and online sexual abuse prevention programmes should be set up to empower children and support parents and educators in understanding and handling online risks. Hotlines should also be developed to enable children to denounce abuse anonymously
  • International cooperation and transnational investigations must be stepped up, since these crimes span hundreds of countries with different legal jurisdictions and law enforcement agencies.

A new joint initiative by the EU and 55 countries will form the Global Alliance against Child   Sexual Abuse Online. This aims to rescue more victims, ensure more effective prosecution, raise awareness and achieve an overall reduction in the amount of child sexual abuse material available online.

To read more about a project aimed at reducing the victimisation of children on the internet, click here on http://ec.europa.eu

Europe needs to scale up measles vaccinations

Over 22,000 cases of measles have been reported in Europe since the start of 2014, so although measles cases have fallen by 50% since 2013, large outbreaks still occur. Over the past two decades, the number of measles cases in Europe has fallen by 96% but WHO is warning that the region is jeopardising its efforts at complete elimination.

The 22,000 cases came from seven countries, including Italy and Germany, where there are pockets of susceptible people who are un- or under-immunised, partly because of barriers to accessing vaccinations, and partly because growing numbers of parents are refusing to vaccinate their children.

In order to control the current outbreaks, all countries must:

  • Improve their ability to detect and investigate all suspected cases
  • Identify chains of transmissions
  • Make high-quality, evidence-based information available to the public on the benefits and risks associated with immunisation

To support European countries in these efforts, the WHO Regional Office for Europe has launched a new European Vaccine Action Plan (EVAP) and offers information on measles and rubella on its website, including reports of epidemiological data, a package of accelerated action for measles and rubella elimination and a framework for verifying the elimination process.

To read more about the seven affected countries, click here   on www.euro.who.int

To read more about the European Vaccine Action Plan, click here on www.euro.who.int

Cervical cancer hits the developing world hard

Cervical cancer is one of the deadliest, yet most easily prevented, forms of cancer for women, causing over 270,000 deaths a year, 85% of which occur in developing countries.

It is estimated that over one million women worldwide are currently living with cervical cancer and the majority of these have no access to health services for prevention, curative treatment or palliative care.

A new publication from WHO, “Comprehensive cervical cancer control: a guide to essential practice” includes the following guidance to make cancer prevention more affordable for struggling health systems:

  • Vaccinate 9 to 13-year-old girls with two doses of HPV vaccine, rather than the current 3-dose schedule as it has proved to be just as effective
  • Use HPV tests to screen women for cervical cancer prevention as this will reduce the frequency of screening
  • Communicate with a wider audience, including adolescents, parents, educators, leaders and people working at all levels of the health system, to reach women throughout their lives

The guide also highlights the importance of addressing gender discrimination and other inequities related to wealth, class, education, religion and ethnicity in the design of health policies and programmes.

To read the full guide, click here on www.who.int

Self Efficacy: An International Literature Review

2009 – 2011 This project built on previous research undertaken in Kent which looked at the values and attitudes of young people that pre-determine their life choices.

The research further explored the rationale that certain young people seem to be more susceptible to ‘risky’ behaviours like crime, drug abuse, anti-social behaviour, homelessness, poor health, benefit dependency and teenage pregnancy. These, in turn, seem to correspond with low levels of self efficacy, which is defined as ‘people’s belief about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives’.

The project’s objectives were to:

  • Better understand how to increase young people’s self-efficacy as part of their journey through life.
  • Explore interventions that are preventative rather than ones that just treat the symptoms.
  • Address the lack of information on self-efficacy by conducting an International Literature Review on the subject.
  • Inform strategists and policy makers so they can commission more effective services for young people.

Perceived self-efficacy is defined as people’s beliefs about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives. Self efficacy beliefs determine how people feel, think, motivate themselves and behave.

The work of Bandura gives a comprehensive explanation of why ‘self efficacy’ is so important and how self efficacy is developed through a young person’s lifecycle, or not, as the case may be.

 

Bien-être: Healthy Communities

2005 – 2007 Bien-être was a cross border two-year healthy schools and communities project between a multi-agency partnership in Kent and Pas-de-Calais, France which started in September 2005.

The objectives of Bien-être were to create cross-border and local learning networks – comprising of those involved with the health and education of children and the well-being of communities – in order to learn from different cultures; to foster mutual understanding of different methods of health and educational service delivery; and to explore opportunities for reducing health inequalities in schools and local communities.

By using food as a catalyst, the project stimulated interest in healthier lifestyles through professional, social and cultural exchanges. Increased community involvement in local projects helped further community development to improve the lives of children and parents in local areas.  The project also increased access for the children, their families and the wider community to a range of cultural activities focused on the enjoyment of healthy eating.

As part of the project, there were annual cross border professional exchange visits and two one-day Festivals of Food, Culture and Sports – one in Pas-de-Calais and one in Kent – bringing together schoolchildren, members of the community, health professionals, head teachers and teachers involved in the Bien-être project, as well as other health and education professionals from the area.