bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a video-based assessment to build authentic public health skills
Authors: Bhatti A 
Published: October 2020

Abstract

Background
Public health education should have strong connections to applied public health practice. Health communication, including an ability to interpret and transmit knowledge, are core competencies for public health graduates. These skills have traditionally been assessed via standard oral presentations. A diversity of tasks can increase student engagement and motivation about assessments. The use of video-based assessments is a relatively new assessment format in post-graduate education. An authentic task was created where post-graduate public health students at Macquarie University, Australia collaborated in groups to create an advocacy campaign video as part of an assessment. These videos were shown at a short film event and students additionally reflected on their experience.

Objective
Can use of a student-produced health promotion video as a team-based assessment task lead to development of: competency in delivering public health communication; technical skills in videography; skills in team engagement and foster deep reflective thought?

Results
On average student grades were higher in the video task than other unit tasks, demonstrating students' competency in delivering public health messages. Unit reflections across three years revealed student benefits included: task enjoyment; feelings of achievement; opportunities to apply learning and new teamwork and videography skills. Unit evaluations found 96% of students reported an increased understanding of advocacy and health promotion and 87% reported the reflective task further consolidated learning. Unit convenor reflections include enhanced student engagement due to novelty, more scope for original presentation of work and similar convening efforts compared to traditional presentations.

Conclusions
This simple innovative video assessment is a practical and authentic way of teaching graduate public health students how to communicate public health messages and could be replicated in other courses.

Key messages
A student-produced video advocacy campaign assessment can offer student engagement and authentic learning in graduate public health education. Implementation of this convenient video-based assessment could be adapted in other courses in public health education.
Reclassifying Deaths: Legal Intervention Deaths (Y35- ICD10) in the city of Sao Paulo (2014-2015)
Authors: Ryngelblum M , Tourinho Peres M F 
Published: October 2020

Abstract

Background
Police violence is a public health issue. Brazil is one of the most violent countries in the world and has one of the most violent police forces. The low reliability of official sources on police killings is recognized worldwide. In Brazil, the two official data sources on police killings are the Criminal Records (Security Department) and the Vital Statistics System that uses the death certificate coding (ICD10-Health Department). The Legal Intervention classification (Y35) presents underreporting when compared to the data from the Security Department. Our study aims to investigate the underreporting by health authorities of the deaths committed by police in the city of Sao Paulo between 2014 and 2015, seeking to identify the death cause coding used.

Methods
We performed a search of all death cases caused by police identified in the Criminal Records, but not classified in their death certificate as Legal Intervention (Y35). In divergent situations, we sought the ICD-10 classifications used. Mortality data were extracted from the death certificate records from the Vital Statistics System and the Security Department database. The databases were linked to identify the same record in both databases. For the linkage, we used the probabilistic method (RecLink software). The three key variables used to identify true pairs were: name of the victim, date of occurrence, and place of death.

Results
Through the linkage, we were able to find 726 true pairs. We highlight: Only 46% of deaths were classified as Legal Intervention (Y35);The other ICD-10 codings used were: Assault by Handgun Discharge- X93 (50%) and Other and Unspecified Firearm Discharge- Y24 (4%).

Conclusions
Our study made possible to reclassify deaths committed by police from the Vital Statistics System. Our method was able to expand the use of the category Legal Intervention (Y35) to more than 100%. The quality of data on police violence in Brazil must be improved.

Key messages
Our study made it possible to reclassify deaths committed by police. We expanded the use of the category Legal Intervention (Y35) in 100%. The data on police violence in Brazil must be improved. Police Violence is a public health issue. The low reliability of official sources is widely recognized. Reclassifying deaths committed by police it is essential for Vital Statistics System in Brazil.
Females and males requesting cervical or prostate cancer screening: Sex differences in self-efficacy
Authors: Gomez Rincon G , Garcia Aparicio L , Torres Ortiz M , Amaya Castellanos C , Idrovo Velandia A 
Published: October 2020

Abstract

Background
Cervical and prostate cancers have an important burden of disease, especially in developing countries. Self-efficacy for requesting screening is a key element in prevention activities. In this study we compared self-efficacy for requesting screening among Colombian females and males, to explore potential joint factors associated with both sexes.

Methods
A mixed study with development design was realized with 50 females and 50 males. First sociodemographic, medical data, and the cancer screening self-efficacy scale (original and ad hoc scale for males) were collected among participants. They were classified according to levels of self-efficacy and their risk factors were identified with robust regression. Semi-structured interviews with individuals with specific characteristics were realized to ascertain with detail about explanations for differences in requesting screening. Elements of the health belief model were the categories analyzed.

Results
Females and males were similar except in religion, occupation, and antecedents of Pap or rectal examination. Self-efficacy for requesting screening was higher among females (adj. β: -15.29, 95% CI:-18.36 to -12.21) and non-believers (adj. β: -5.38, 95% CI: -10.33 to -0.44). 27 individuals (18 males and 9 females) with low and high self-efficacy, and non-believers (atheists) were selected for interviews. Participants suggested that females are more susceptible than males because men need to feel symptoms. Shame and discomfort are barriers expressed by both sexes. Machismo is a strong barrier to request screening. Religion associate sex with impurity and it is a barrier among females. Health care services only focus on female screening.

Conclusions
Gender roles and religion (Catholicism and other Christian) elements are cultural expressions that determine the request of cancer screening. Further interventions should consider cultural elements to improve screening coverage.

Key messages
There are important sex differences in requesting cervical or prostate cancer screening. Culture (gender roles and religion) expressions determine cancer screening.
Uptake of cervical cancer screening in Kuwait: A cross-sectional study
Authors: Tolma E , Alawadhi E , Longenecker J , Al-Wotayan R , Tawheed E , Albahar S 
Published: October 2020

Abstract

Background
Despite the low incidence of cervical cancer in Kuwait in 2018, it is projected that it will increase by 48% by 2035. This is of concern considering that cervical cancer is a preventable disease if detected early. With limited research in this area in Kuwait, we sought to assess the prevalence of cervical cancer screening (CCS) among Kuwaiti women.

Methods
This study is part of the WHO's 2014 STEPS risk factor surveillance study. A representative random sample (n = 3915) of Kuwaiti citizens was recruited (response rate= 89.2%). CCS was assessed with the question “Have you ever had a screening test for cervical cancer using any of the methods described above”. All women aged 21-69 years who responded to the CCS question (n = 2183) were included in the analysis. Independent variables included age, area of residence, marital status, level of education, work status, smoking status, BMI level, history of CV disease, and history of diabetes. Statistical analysis included descriptive statistics, bivariate analysis, and multivariable logistic regression adjusted for participants' characteristics.

Results
The overall weighted CCS prevalence was 15.7% (95% CI [14.3-17.4]). CCS was associated with age (OR = 5.0 [2.5-10]) for age group 60-69, and OR = 3.1 [1.9-5.1] for age group 45-59 compared to the age group 21-29, area of residence (ORs ranged from 0.3 to 0.5 for those living in different governorates compared to those who lived in the Capital), marital status (OR = 4.4 for married and OR = 5.2 for divorced/widowed compared to those who were single), and level of education (ORs ranged from 2.7 to 2.9 for those who completed at least high-school education compared to those who did not).

Conclusions
The current uptake of CCS among Kuwaiti women is low. Disparities exist in terms of age, area of residence, level of education, and marital status. More efforts are needed to promote CCS through an organized screening program while considering the existing disparities.

Key messages
The current use of cervical cancer screening among Kuwaiti women is low. More efforts are needed to promote cervical cancer screening while paying attention to existing socioeconomic disparities.
Nutritional Status and Diet in Elderly with Low and High Socioeconomic Status
Authors: Zhu Y , Minović I , Dekker L H , Eggersdorfer M , van Zon S K R , Bakker S J L , Navis G J , Riphagen I J 
Published: October 2020

Abstract

Background
Socioeconomic status (SES) patterned health disparities have been related to differences in dietary intake, especially in the elderly. Still, it is not known to what extent these differences culminate in vitamin deficiencies, as most studies have assessed nutrient intake, instead of measuring nutritional biomarkers. Hence, we aimed to objectively assess nutritional status in elderly with low and high SES and to investigate whether potential differences therein were mediated by diet.

Methods
1605 individuals (60-75 years) were selected from the LifeLines Cohort Study to create two gender-matched groups with different SES. Nutritional status was assessed by measuring folic acid, vitamin B6, B12, D, A, E and K in the collected samples. SES-groups were defined according to highest completed education as high and low, and dietary quality was assessed the Lifelines Diet Score. Multiple linear regression and logistic regression were first used for the association between SES and vitamin status; and mediation analysis was used to explore the relationship of SES, diet and vitamin status.

Results
The overall prevalence of vitamin deficiency ranged from 4.1% (vitamin B6) to 19.5% (folic acid). The low SES group had significantly poorer status (p ≤ 0.04) of most vitamins, including the B vitamins (i.e., folic acid, B12 and B6) as well as multivitamin deficiencies (p ≤ 0.02). Low SES was independently associated with decreased folic acid, vitamin B6, vitamin B12, and vitamin A serum concentrations (p ≤ 0.03 for all). Diet quality was found to partially mediate the association between SES, and folic acid (39.1%), vitamin B6 (37.1%) and vitamin B12 (37.2%)(P ≤ 0.03).

Conclusions
Low SES is a risk factor for suboptimal nutritional status. The association between SES and nutritional status can be partially explained by diet quality, suggesting that policy makers can mitigate socioeconomic inequality in nutritional status by improving diet quality among elderly.

Key messages
Revealed that low SES was a risk factor for a suboptimal nutritional status among the elderly and a possible self-reinforcing trap has formed which causes low SES and hidden hunger to persist. Highlighted the importance of diet quality in socioeconomically patterned health disparities and indicating the need for SES-tailored public health strategies.
Diabetes vulnerability in Rome
Authors: Vaccaro C , Addonisio A , Lenzi A , Napier D , Volkmann A M , Dotta F , Crialesi R , Frontoni S , Baroni M , Morviducci E 
Published: October 2020

Abstract

Background
To understand the presence and impact of social and cultural factors on health vulnerability it is important for improving diabetes care and management. In fact, through the social dimension, it is possible to identify the priorities and attitudes towards diabetes and diabetes care among those living with the condition.

Methods
The study was carried out as part of the global Cities Changing Diabetes programme, involved a sample of individuals living with diabetes in the Rome metropolitan area and employed mixed-method and qualitative approaches to data collection and analysis (survey, sorting procedure and focus group).

Results
Four specific sub-groups of participants have been identified, each with distinct but shared priorities and attitudes towards diabetes: Health conscious thanks to the context; Medicalized elderly people; Fatalistic citizens; Worried but undisciplined young people. The connection between the place where you live and the possibility to adopt a healthier lifestyle was confirmed. For these patients, the disease is mainly characterized by its relationship with food and its connections with psychological aspects are also relevant.

Conclusions
An important issue concerns information and the different understandings of diabetes. A clear need emerged for further elaboration of the various aspects of a disease that tends to be underestimated also by those who have it. Another aspect concerns the importance of the living environment and consequently of the actions on its urban planning, mobility, but also in everyday life organization, as factors that can make a difference in properly managing the disease. These results are very important to promote a joint action, that have to involve public and private stakeholders, in order to improve treatment opportunities and quality of life of people facing diabetes every day in the Rome metropolitan area.

Key messages
An important issue concerns information. A clear need emerged for further elaboration of the various aspects of a disease that tends to be underestimated also by those who have it. The living environment in important too and the actions on its urban planning, mobility, in everyday life organization, as factors that can make a difference in properly managing the disease.
The macro determinants of medical abortion rates in Europe: a matter of gender equality?
Authors: Miani C 
Published: October 2020

Abstract

Background
Medical abortion is one of the WHO recommended methods for safe and effective first trimester abortion. It is often seen as an emancipating procedure allowing women to be more in control of their abortion, as opposed to surgical procedures where the surgery is “done to” the woman by a doctor. In countries where medical abortion is legal and available, rates of medical abortion (vs. surgical abortion) vary greatly, e.g. in Europe from 24% to 98%. We hypothesised that these differences may mirror how empowered women are in different aspects of their lives and be in part explained by gender (in)equality at the country level.

Methods
We conducted correlation and regression analyses to assess the association between medical abortion rates and gender inequality in Europe, using several macro-level markers of gender equality such as national gender equality indices and rates of violence against women. The relevance of other structural factors, such as health system and abortion care characteristics was also investigated.

Results
Seventeen countries were included. Although the sample size was small, results pointed toward an association between several markers of economic gender equality and medical abortion rates. The Gender Gap Index (corr. coeff: 0.52, p = 0.03) and its economic component (corr. coeff: 0.64, p = 0.005), as well as the economic component of the Gender Equity Index (corr. coeff: 0.68, p = 0.003), were all positively associated with the outcome. Other dimensions of gender equality (e.g. political participation; violence against women) and health system factors (e.g. date of introduction of the method; type of abortion providers) were not associated with the outcome.

Conclusions
Our results suggest that women's empowerment in the economic sphere may have repercussions on the use of abortion care, potentially influencing what method of abortion the women ask for and what method they are offered.

Key messages
Barriers to the use of medical abortion go beyond the law (if a method is legal/available or not) and include structural determinants, such as gender equality. Higher levels of economic gender equality are associated with higher rates of medical abortion, highlighting the relationship between gender equality and choice of method of abortion.
Trajectories of socio-economic position over four time points and mortality: The role of gender
Authors: Koupil I , Goodman A , Heshmati A , Mishra G 
Published: October 2020

Abstract

Background
Studies investigating the effect of social mobility on mortality in Sweden have used socioeconomic position (SEP) at only two time points and traditional methodological approaches. Our recent study has used SEP at four time points, but not employed latent class analyses when investigating the relationship between SEP trajectories and mortality in later life.

Methods
A cohort of 14,192 live births at Uppsala University Hospital between 1915-1929, of whom 97% were traced through parish records until routine registers became available in the 1960s. 5729 men and 5607 women were alive and living in Sweden in 1980. SEP was measured as social class of the head of household: at birth, in childhood (age 10, +/- five years), in adulthood (age 30-45, in the 1960 Census), and in later life (age 50-65, in the 1980 Census). Latent class analysis was employed to identify social class trajectories and Cox proportional hazard models used to estimate all-cause and cause-specific mortality (data from Causes of Death Register).

Results
Compared to men and women with stable high SEP trajectories, we found a higher risk of death from circulatory disease among men with stable low (HR 1.56, 95%CI 1.29-1.87), stable middle (HR 1.28, 95%CI 1.06-1.55) and upwardly mobile from low (HR 1.35, 95%CI 1.10-1.66) SEP trajectories, as well as in women with stable low or mobile from low to middle SEP trajectory (HR 1.27, 95%CI 1.02-1.59). SEP trajectories and total mortality showed similar, albeit, weaker associations in both genders. SEP trajectories were gender-specific and associations of SEP trajectories with circulatory disease mortality tended to be weaker in women.

Conclusions
Men's and women's socioeconomic position during childhood and over the life course affect their risk of late life all-cause mortality, and death from circulatory disease in particular. Improvements in social conditions at early stages of the life course are likely to contribute to reducing mortality at old age.

Key messages
Men’s and women’s socio-economic position during childhood and over the life course affect their risk of late life all-cause mortality and mortality from circulatory disease in particular. Trajectories of socioeconomic position across life course appear to be related to cause specific and total mortality in a gender specific pattern.
Revisiting the social determinants of health agenda from the global South
Authors: Borde E 
Published: October 2020

Abstract

Background
One of the most marked characteristics of the global social structure is the existence of substantial social inequalities in wealth, which also find expression in health inequalities between and within countries. In an effort to provide an overview of the conceptual debates shaping the mobilisation around social determinants of health and health inequities, two of the most influential approaches in the field are compared: the WHO Commission on Social Determinants of Health approach (CSDH), strongly influenced by European Social Medicine, and the Latin American Social Medicine and Collective Health (LASM-CH) Social determination of the health-disease process approach, hitherto largely invisibilized.

Methods
A comprehensive literature review was conducted in three databases (Lilacs, Scielo, Medline/Pubmed), reference lists of selected papers, and citations in Google Scholar, including book titles.

Results
It is argued that the debates shaping the SDH agenda do not merely reflect terminological and conceptual differences, but essentially different ethical-political proposals that define the way health inequities are understood and proposed to be transformed.

Conclusions
While the health equity and SDH agenda probably also gained momentum due to the broad political alliance it managed to consolidate, it is necessary to make differences explicit as this allows for an increase in the breadth and specificity of the debate, facilitating the recognition of contextually relevant proposals towards the reduction of health inequities.

Key messages
Debates shaping the SDH agenda do not merely reflect terminological or conceptual differences, but distinct ethical-political proposals. Differences need to be discussed and made explicit to guide the development of contextually relevant efforts to reduce health inequities.
Exploring the relation between socioeconomic position and DNA methylation in a European population
Authors: Petrovic D , Carmeli C , Bodinier B , Chadeau-Hyam M , Ehret G , Dhayat N , Ponte B , Pruijm M , Bochud M , Stringhini S 
Published: October 2020

Abstract

Background
Previous investigations have reported that adverse socioeconomic circumstances across the life-course lead to the alteration of major biological processes, eventually resulting in a higher disease risk and premature death. In particular, a low life-course socioeconomic position (SEP) has been associated with a modified epigenetic signature of loci involved in inflammation, the physiological response to stress, and other regulatory processes.

Methods
In this study, we investigated the association between nine indicators of SEP across the life-course and the differential methylation of 451'000 genome-wide CpG markers, using data from 690 adults included in a Swiss population-based study. We further examined the interrelations between the SEP-related CpGs, and the biological pathways in which the identified markers are involved.

Results
Three SEP indicators in adulthood were associated the differential methylation of 161 genome-wide CpG markers, whereby 156 CpGs were less methylated in people with low versus high SEP. Among the identified CpGs, a substantial proportion of markers were no longer associated with SEP upon accounting for health behaviors and cardiometabolic disorders. In addition, the identified CpGs were found to be involved in immune, inflammatory, and cancer-related processes.

Conclusions
Our results support the hypothesis that adverse socioeconomic circumstances may lead to the dysregulation of inflammatory processes, eventually resulting in the occurrence of serious chronic conditions such as atherosclerosis, diabetes, or cancer.

Key messages
Socioeconomic position is a major determinant of health-related outcomes. Epigenetic modifications may constitute a biological mechanism through which socioeconomic circumstances affect health.