bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the local health-enhancing physical activity policies in the French Riviera
Authors: Racine A N , Garbarino J M , Massiera B , Vuillemin A 
Published: October 2020

Abstract

Background
Policy is one of the levers to initiate structural and environmental changes to foster health-enhancing physical activity (HEPA) promotion. However, little is known about local evidence to support governments in their policies to promote HEPA. This study aims to analyze the local HEPA policies development in French mid-size cities.

Methods
Mid-size cities from 2 counties of the French South Region were targeted (n = 17). In each city, a local HEPA policy analysis tool, CAPLA-Santé, was administered to key informants heading the departments of sport, health and social. CAPLA-Santé is a local policy analysis tool adapted from the national HEPA policy analysis tool (HEPA PAT version 2) developed by the World Health Organization. Data were collected through semi-structured interviews and documents analysis.

Results
A total of 10 mid-size cities were volunteered to participate. Key informants from sport (n = 10), health (n = 5) and social (n = 6) departments were interviewed. Several written HEPA policies were formalized in 6 cities, 4 of them based their policies on scientific evidences or a national policy. These policies (n = 14), were mainly from the sport (n = 8) and the health sectors (n = 4). Some cities had a department head to ensure cross-sectoral collaboration (n = 3). Key informants reported that the support of national policies, the commitment of elected officials and an important local stakeholders' network could facilitate the HEPA promotion; whereas lack of intersectoral collaboration and resources could be a limitation.

Conclusions
The results help to better understand the local HEPA policies, highlighting some barriers, facilitators and perspectives. These findings could be valuable to scale up the HEPA promotion at the local level.

Key messages
Local policymakers had difficulties to adopt an intersectoral and global approaches in HEPA promotion. Using local HEPA policy analysis tool can provide evidence to support policymakers.
Norwegian parents' views on nutrition policy measures and responsibility
Authors: Roos G 
Published: October 2020

Abstract

Background
Norwegian nutrition policy has during the last 50 years shifted from a focus on state concerns over the common good and social welfare towards increased individual responsibility and a focus on active consumers who make conscious choices. This paper investigates division of responsibility between the state and individuals by analysing parents' views on nutrition policy measures and responsibility for healthy eating.

Methods
In 2019, Norwegian parents with children aged 1-16 years (N = 1085; 59% women and 41% men), completed a web-based survey on children's food and clothing consumption. The questionnaire included questions about individual and state responsibility for healthy eating and nutrition policy measures.

Results
Preliminary results indicate that there is consensus among parents that health is an individual responsibility (75%), whereas simultaneously 30% indicated that the state should not interfere with people's eating. Among nutrition policy measures parents agree that the state should use food price regulation to support healthy eating (71%) and 94% agree that there should be lower prices (VAT) on fruits and vegetables. The majority of parents (65%) think that marketing of unhealthy food to children should be banned, and that the packed lunch should be replaced by a school meal, while the opinions around keyhole labelling are somewhat more varied (46% agree that the keyhole label makes choosing healthy food easier). Further analysis in relation to background (education, income etc.) and food consumption are planned.

Conclusions
Healthy eating is considered a personal responsibility by Norwegian parents. They support nutrition policy measures and especially agree that the state should use price regulation to endorse healthy eating.

Key messages
Consumer views on nutrition policy measures should be taken into account. Norwegian parents support state regulation, especially food price regulation measures.
Political analysis of the neonatal screening for severe combined immunodeficiency - Curitiba, Brazil
Authors: Lima D R L , Goiozo P F I , Sanches A , De Carvalho E , Carvalho H A , Silva C L 
Published: October 2020

Abstract
Severe Combined Immunodeficiency (SCID) is the most aggressive form of primary immunodeficiencies, being able to death within 2 years after birth. In the USA, the screening found that the incidence of SCID was double that previously stipulated, before screening. Israel, Taiwan, Spain and others European countries are also testing for SCID. The long-term survival of patients diagnosed and treated before 4 months of life reaches 94%. Brazil does not perform neonatal screening for SCID through the Public Health System (SUS), numbers are unknown and under-diagnosed, even the treatment for SCID is funded by SUS. Analyze the political dimensions of the bill that aims to implement neonatal screening for SCID in Curitiba, Brazil. Participatory research was carried out between March - October 2019 and, bibliographic research on policy analysis in the context of emerging countries, to understand the criteria are taken into account for the political agenda, the influence of interest groups and the influence of the political arena in the implementation of a public policy through policy analysis. The project is pending in the municipal legislature of Curitiba and faces issues related to the financing of the implementation - a wide range of dependent variables act in the construction of a public policy. Its materialization, although important for public health, must consider real possibilities of implementation. In parallel, independent of the bill, a screening pilot project is under preparation by doctors, academics, and civil society. Brazil has a feasible technique that can be implemented on a large scale for neonatal SCID screening. However, although strongly recommended by the medical community, the implementation of this policy can be unviable by political and financial issues.

Key messages
The implementation of a public policy involves decisions between institutions, rules of the game and political forces. Early diagnosis may reduce treatment costs, requiring public policies for SCID.
A critical discourse analysis of health in Swedish integration policies
Authors: Svanholm S , Viitasara E , Carlerby H 
Published: October 2020

Abstract

Background
Previous research has indicated that migrants risk facing inequities both internationally and in Sweden; integration policies are therefore important to study. How health is described in policies affects how health interventions are approached. A discourse analysis offers a way of understanding how health is framed within the integration policies of the Establishment Program. The aim was to critically analyse the health discourses used in Swedish and European Union (EU) integration policies.

Methods
A critical discourse analysis, inspired by Fairclough, was performed on integration policies related to Sweden, on local, regional, national and the EU level. The policies of the Establishment Program, which focuses on newly arrived migrants (refugees, persons of subsidiary protection and their relatives who arrived through family reunification), were chosen for the analysis, and 17 documents were analysed in total.

Results
The analysis of the documents showed that although no definition of health was presented, health discourses were expressed in the form of the medicalization of health and the individualization of health. This not only by the terminology used, but also in how the healthcare sector was considered responsible for any health related issue and how individual health behaviours were of focus in interventions to promote health.

Conclusions
A pathogenic approach to health was visible in the policies and individual disease prevention was the main health focus. The results showed similarities to previous research highlighting how a particular understanding of health in a neoliberal context is formed.

Key messages
Health as a resource is missing in the integration policy documents. Viewing health as an individual quality puts the responsibility of promoting health on the individual.
Public health policy and medical unionism in the context of collapse of Brazilian democracy
Authors: Guimarães-Teixeira E , Delgado P , Machado M H , Camargo A 
Published: October 2020

Abstract

Issue
This is a report about an editorial initiative to contribute to the debate on the crisis of trade unionism and public health in Brazil.

Description of the Problem
The Rio de Janeiro Doctors Union (SinMed-RJ), the first trade union of liberal professionals in Brazil, began its activities in 1927 and has completed nine decades. It kept present in the political life, in the process of drafting labor laws, subjected to the brutal intervention of security agencies during the military dictatorship, and in the street struggle for democratizing access to health in the 1980s. It is yet part of the history of the struggles for the re-democratization of the country and the construction of a universal public health policy. Together with The Brazilian Center for Health Studies (Cebes) it fights for the construction and consolidation of the Unified Health System (SUS) and the achievements of the 1988 Citizen Constitution, actions that had a major impact on the trade union and on public health.

Results
In 2017, the government that emerged from the 2016 judicial-parliamentary coup, made changes to labor legislation, destroying the legal framework for the defense of work and discontinuing the financial of trade unions. In 2019, we were witnessing the struggle of combative and socially based unions for the survival of their entities. The SinMed-RJ promoted debates on the role of the media in deconstructing democracy and the precariousness of medical work, while actively supporting the struggle of doctors in defense of their rights.

Lessons
Cebes and SinMed-RJ met against the privatization health, an important agenda of debate and action. From 2019, there had been a growing increase in measures to deconstruct public policies and labor protection, breaking the social legitimacy of state institutions, retracting the democratic space, deepening inequality and unemployment. This agenda is urgent to be widely debated for the whole society of a country in crisis.

Key messages
The major impact of this work was to include the public health challenges of Brazil in the agenda of the trade union, and to fight to rescue the democracy in Brazil. The major impact was to work with other institution on health studies and publish a special number of a free publication in honor of nine decades of the first union of liberal professional in Brazil.
Times of change in complex environments - Evaluating hospital co-payments in Palestine refugee camps
Authors: Valente de Almeida S V , Ghattas H , Paolucci G , Seita A 
Published: October 2020

Abstract
We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare.
The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider.
After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient.
We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making.

Key messages
We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.
Family caregiving in an aging society: Key policy questions
Authors: Vinarski H , Halperin D 
Published: October 2020

Abstract
An aging population, attended by an increase in chronic diseases and disability, together with decrements in health among the elderly, require considerable health care resources being expended on long-term care needs in the home environment at the community level. Increase in life expectancy, and more substantially, the disproportionate increment within the very oldest age groups and in the number of elderly whose activities are limited by some sort of physical or cognitive disability have significantly increased family care needs. Such demographic shift and socioeconomic changes throughout the developed world are making elderly care an increasingly important public policy issue. Particularly, one of the principal foci of policy makers should be supporting and nurturing family care. This paper focuses on the case of Israel. Like many industrialized countries, Israel faces the challenge of caring for a growing number of vulnerable older people while advancing adequate policies to support both elderly and their informal caregivers. Currently, the demands for family caregivers has increased drastically, and, studies predict that the personal, social, and economic costs of caregiving, which have risen dramatically over the last three decades, will only continue to increase. This paper focuses on the extent to which current legislation supports primary informal caregivers in Israel. A review of the legislation and benefits has indicated that the aid supplied is limited mainly because their application is relevant only in extreme cases where the elderly need constant supervision or care in institutions. Their contribution to most elderly and their families is only partial. The rights afforded to the informal caregivers are relatively few, are limited and are all concentrated in the domain of occupational support, and this also in a restricted manner.

Key message
Family caregiving in an aging society: Key policy questions.
More harm than good? Building a framework to identify adverse effects of public health interventions
Authors: Stratil J , Oliver K , von Philipsborn P , Movsisyan A , Rehfuess E A 
Published: October 2020

Abstract

Background
While the importance of adverse events of medical interventions is widely recognized, adverse effects of public health interventions remain a neglected topic. This project aims to develop a framework to guide researchers and decision-makers to systematically reflect on and identify potential adverse effects of public health interventions.

Methods
We conducted a mixed-method systematic review of theoretical and conceptual publications on adverse events of public health interventions to develop a preliminary framework employing best-fit framework synthesis. We used the WHO-INTEGRATE framework as a starting point for the synthesis, a multidimensional evidence-to-decision framework developed for complex interventions in complex systems.

Results
The framework includes two interlinked parts: The first maps domains in which potential adverse events might arise. Drawing on the WHO-INTEGRATE framework, these domains include aspects related to health, but also domains related to societal, economic, and environmental implications. The second part maps general mechanisms through which public health interventions can lead to adverse effects (e.g. reactive behaviour change, increase of labelling and stigmatization, and exposure to environmental risk-factors).

Conclusions
The framework will be advanced in the second phase of the project through empirical studies of harmful effects in public health interventions, which we will identify through an overview of systematic reviews. Adverse effects of public health interventions are currently not sufficiently considered in research and practice. Taking them into account is essential for informed decision-making and establishing appropriate countermeasures. Our framework could be a valuable asset for researchers and policy makers in developing, implementing and evaluating public health interventions.

Key messages
Awareness of the adverse effects of public health interventions is essential for informed decision-making and establishing countermeasures. This framework supports researchers and decision-makers in systematically reflecting on and identifying adverse events when developing, piloting, implementing or evaluating public health interventions.
Profile of incarcerated women in the interior of Brazil and the challenge of education in prison
Authors: Faquim J , Macedo J , Oliveira J , Machado S , Ivancko G , Costa K , Alves M , Oliveira T 
Published: October 2020

Abstract
According to the Ministry of Justice and Public Security, Brazil is fourth in the world position in relation to the absolute size of female prison population, with 42.000 women deprived of freedom (2016), behind the United States, China and Russia. Around 50% are young (&lt; 29 years old), 62% are black and 66% have not yet attended high school. This study aimed to characterize the profile of women incarcerated in a penitentiary in the interior of Brazil, through the survey of sociodemographic data, education, health, legal and life expectations. This is a descriptive and exploratory study conducted with 68 women (20 to 67 years old) in 2019 and 2020. Most women declared themselves black or brown (56%), incomplete elementary school (42%), have work experience (73%). Around 69% reported needing health treatment and 76% have already used psychoactive substances including alcohol, cigarettes, marijuana, cocaine or crack. The main reasons that led to the arrest were drug trafficking (54%) and theft (26%) and the majority (53%) are repeat offenders in prison system. Regarding the biggest dream of life, the main answers were related to family life (44%), having a job (26%) and access to education (20%). With these results, an extension project was proposed to offer a professional qualification in vegetable gardens, aromatic and medicinal plants for women prisoners. In addition to professional qualification, the project is dedicated to promoting debates on map of life, ethics, human relations, citizenship, gender, women's rights and health, quality of life, body and verbal expression, digital inclusion, food and nutrition security, entrepreneurship, cooperativism, solidary economy, rights and duties of the worker, aiming at better employment conditions. This research contributed to articulate actions between university and society, empower women through access to education and allowed the work team to develop competencies related to collaborative work and interdisciplinarity.

Key messages
This study aimed to characterize the profile of women incarcerated in a penitentiary in Brazil, through the survey of sociodemographic data, education, health, legal and life expectations. This research contributed to articulate actions between university-society, empower incarcerated women through access to education and allowed the work team collaborative and interdisciplinarity work.
#CroakeyGO: Walking as an act of journalism to engage not distance the public in health reporting
Authors: Williams M , Sweet M , Armstrong R , McInerney M , Ward M 
Published: October 2020

Abstract
Health as it is reported in mainstream media is narrow and communities are often excluded, despite being where the experience of health occurs. A wide range of research indicates that it is through narratives of community members that media and health messages are best conveyed, and community members now have a range of platforms for quickly conveying information to each other and the media. However, there have been surprisingly few innovations for journalists to use this material, or to better connect with the public and report more accurately about health.
Our experience across several journalism projects demonstrates how quickly and deeply health content can be developed in collaboration with communities. One example is #CroakeyGO - an innovation in public interest journalism that gathers, walks and talks with community members together at a defined time and location about health-related matters.
#CroakeyGO brings together diverse voices from local communities - people who might otherwise not connect. This stimulates discussion about health issues beyond the individual, including system- and environmental-level issues that impact local lives. #CroakeyGO also means respecting Indigenous peoples' connection to Country on which we walk and reflecting on intergenerational inequities and solutions Indigenous knowledges offer.
To date we have published more than 40 articles from #CroakeyGO events around metropolitan and regional Australia. We have collaboratively produced social media and other editorial content with community members and stimulated enduring networks for health planning, advocacy and research. #CroakeyGO reinforces that improving health in a community requires more than just additional services, and that transformations in journalism can facilitate and support rather than hinder collective action.

Key messages
Innovations in journalism are required and possible to improve health reporting. Communities are willing to engage in health reporting.