bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of social stress and strain on cognitive function in older people
Authors: Lindert J , Paul K C , Lachman M , Ritz B , Seeman T 
Published: October 2020

Abstract

Background
Social stress and strain, especially discrimination and inequality might have an impact on memory and cognitive function. This is a major concern for older individuals, their families, communities and societies. We sought to assess changes in episodic memory (EM) and executive functioning (EF) among men and women in the 'Midlife in the United States' (MIDUS) cohort study, to delineate variations in EM and EF by gender, and to determine the impact of social stress/strain at three levels (family, work, society) on longitudinal changes in EM and EF in men and women.

Methods
We used data from the MIDUS study - a national probability sample of non-institutionalized, English speaking respondents aged 25-74 living in the 48 contiguous states of the United States. The initial wave in our study (1995) included 4963 non-institutionalized adults aged 32 to 84 (M = 55, SD = 12.4). The dependent variables are EM and EF, which were assessed with the Brief Test for Cognition. The independent variables were social stress and discrimination variables at the family/partner level, the work level and the society level, assessed with validated discrimination measures. To assess cognition changes we estimated adjusted linear regression models.

Results
Women report more perceived inequality for their family and more family strain than men across all age groups. After controlling for other explanatory variables, the main effect on cognition for all age groups was found for perceived inequality of one's family opportunities.

Conclusions
Reducing social stress and providing opportunities might be an important measure to support episodic memory and executive functioning in aging populations.
Future mechanisms for funding research on unhealthy commodities – criteria for industry-supported research funding programs
Authors: Cohen J 
Published: October 2020

Abstract
Research funding is scarce and some argue that commercial enterprises not only can, but should, fund extramural research. Others are concerned by the evidence that commercial funding of research is used by these commercial interests to subvert the scientific process, to gain credibility and to advance their own financial interests, without regard to broader societal values and needs. A key question is whether there might be a funding model whereby industry-supported research funding programs are acceptable to the public health community and that support broader societal goals. We developed eight criteria for evaluating research funding programs that include support from the tobacco industry: (1) transparency and independence; (2) competitive funding process; (3) ownership of data and freedom to publish; (4) independent research agenda; (5) governance; (6) protection against conflict of interest; (7) industry public relations gains that counteract public health; and, (8) feasibility. We will discuss the applicability of similar programs for funding research on other unhealthy commodities, and on the practices of other harmful industries such as the fossil fuels industry.
Sustainability of food systems, supported by public institutions, case of Slovenia
Authors: Gabrijelčič Blenkus M 
Published: October 2020

Abstract
Slovene National nutrition and PA strategy 2015-25 is comprehensively addressing food systems. Public institutions, offering food programs to specific population groups such as children in kindergartens, students in primary and secondary schools, older adults in residential homes, patients in hospitals, all create a substantial demand for foods, purchased partially from the public budget. For food programs there are nutrition guidelines, for school environment mandatory in the School Nutrition Law. The extent of the foods, purchased in short food chains has the effect on local economies in rural communities, on the environment and also on the quality of foods per se, as food could be harvested when fully ripped. Slovenia has established the Catalogue of foods as a support for transparent food public procurements in 2018.
As children spend almost a third of their day in kindergarten or school and consume a large part of their daily energy intake in educational environments, such types of environments present important factors in the development of child nutrition habits. Strong evidence of the importance of access to healthy and balanced nutrition in schools for children's health is available, and a nutritionally regulated school environment is associated with a lower risk of childhood obesity, which can also be facilitated by a transparent and quality-oriented procurement system. In Slovenia, all schools have kitchens, which serve up to four fresh cooked meals per day (breakfast - uptake around 17% of all Slovene primary school children, mainly in younger age groups, mid-morning snack - uptake around 98%; lunch, uptake around 70%, afternoon snack - uptake around 20%). Around one quarter of Slovene primary school students from lower SES get school meals fully subsidized. Total ban on vending machines in primary schools, preventing from snacking, is in place since 2010. Organized school nutrition enables women in Slovenia to enter labour market equally.
Study of the impact of anti-tobacco legislation on public health in the Russian Federation
Authors: Agishina T A , Kontsevaya V A , Gambaryan M G 
Published: October 2020

Abstract

Background
Smoking increases the risk of developing many diseases, both non-infectious and infectious. On February 23, 2013, the Russian Federation adopted an anti-smoking law, which provided for a two-stage ban on smoking in public places. Since June 1, 2013, smoking has been banned in schools, hospitals, public transport, railway stations, workplaces, and since June 1, 2014 - in trains, hotels, bars, restaurants.

Purpose
To study the dynamics of monthly hospitalization rates for respiratory diseases and acute otitis media in three regions of the Russian Federation (Chuvash Republic, Samara and Arkhangelsk regions).

Methods
A retrospective analysis of the monthly hospital incidence of pneumonia of various etiologies (ICD-10 J12-J18), other acute lower respiratory infections (J20-J22), asthma (J45), status asthmaticus (J46) and acute otitis media (H65.0, H65.1, H66.0) from 2012 to 2017. The data were analyzed by the method of interrupted time series. The information was provided by the regional Fund of Medical Insurance.

Results
Two control points were identified - June 2013 and June 2014. We demonstrated the reduction of hospitalization rates for acute lower respiratory infections and pneumonia immediately after each of the two stages of the anti-smoking policy implementation in all regions studied. In the Arkhangelsk region, the decrease was 19% in 2013 and 22% in 2014, in the Samara region - 20% and 23%, and in the Chuvash Republic - 31% and 39%. The reduction of hospitalization for asthma, status asthmaticus and acute otitis media was observed only in Chuvash Republic: the decrease in the number of hospitalizations for asthma and status asthmaticus was 11% in 2013 and 12% in 2014, and for acute otitis media - 25% and 35%. In other regions the decline was non-significant.

Conclusions
Anti-tobacco legislation leads to an immediate and significant reduction in the number of hospitalizations for lower respiratory tract infections.

Key messages
The ban on smoking in public places reduces infections of the lower respiratory tract and acute otitis media. Anti-tobacco legislation has a positive impact on public health.
International benchmarking for health policy evaluation: the French National Health Strategy
Authors: Luciano L , Low E , Rey S , Gaini M 
Published: October 2020

Abstract

Background
International benchmarking is a valued source of inspiration and learning for policy-makers to develop successful public health policies. Through comparison, the external coherence of one policy can be measured and its objectives redesigned. The French national health strategy (SNS) 2018-2022 comprises the French health policy framework focusing on four priority areas. The aim of this study was to conduct international benchmarking of current national health strategies to explore the external coherence of the SNS and evaluation methods.

Methods
A scoping review was conducted through available governmental and public health agencies' websites to survey national/federal health strategies in select high-income countries.
Strategical approaches, governance and policy duration were compared with four health priorities of the French SNS: prevention, social/territorial inequalities, quality of care, innovation. A descriptive analysis of these strategies' evaluation methods, including relevant indicators, was executed.

Results
Out of 18 countries selected, 11 have a current strategy akin to the four priorities of the French SNS, with a timeline stipulated to implement the policy. The strategies of Australia and Switzerland, out of nine countries with strategies covering these areas, bear the closest resemblance to the French SNS. Evaluation methods varied largely across countries.

Conclusions
The majority of countries contain a health strategy with a longer duration compared to the French SNS, irrespective of governance. Similar priorities were found for countries with a national health strategy, with other countries developing at least prevention plans. Most countries provided only partial evaluation methods or overall health target indicators, to be taken into account for the development of the French SNS evaluation plan

Key messages
International benchmarking is essential to identify best practices in health policy design. As a result, future French health strategies may benefit from a longer duration of implementation. If great efforts were put in place in France to build a strategy evaluation plan, other countries focused mostly on implementation reports or monitoring national health targets through indicators.
The Association of Socio-demographic Determinants and Mammography Screening in women in Serbia
Authors: Susnjevic S , Milijasevic D , Mijatovic Jovanovic V , Niciforovic Surkovic O , Kvrgic S , Tomasevic T 
Published: October 2020

Abstract

Introduction
Serbian screening mammography programs target women 50-69 years with biennial screening.

Methods
Research was conducted as a cross-sectional study on a sample of 2784 women aged 50-69 years in Serbia, as a part of the Health Survey in Serbia, 2013. The association between the socio-demographic determinants as independent variables, and mammography screening (within the past 2 years) as dependent variable were examined using univariate and binary logistic regression. Multivariate model were adjusted for marital status, education, employment status, DHS Wealth Index, type of settlement and self-perceived health. The minimum level of significance was p &lt; 0.05.

Results
Only 22.2% of women aged 50-69 have done mammograms within the past 2 years in Serbia. In binary logistic regression model as predictors for a mammogram were singled out level of education, wealth index and self-perceived health. Women with medium level of education have 1.4 times higher chance to perform a mammogram in relation to those with low education (OR = 1.4; 95%CI 1.12-1-80), while women with high level of education have 1.8 times higher chance to do a mammogram in relation to those with low education (OR = 1.8; 95%CI 1.33-2.58). Women with good financial situation were 1.4 times more likely to perform a mammogram in relation to those with poor financial situation (OR = 1.4; 95%CI 1.05-1.80). Women who perceived their health as well have 26% less chance to do a mammogram compared to those who perceived their health as a poor (OR = 0.74; 95%CI 0.56-0.97).

Conclusions
This study showed the disparity in the prevalence of mammography utilization. The predictors for mammogram performance among women were: high level of education, high wealth index and self-perceived health as poor.

Key messages
The only breast cancer screening test that has been proven effective in organized, population-based programs is mammography screening. Screening mammography reduces the risk of death due to breast cancer. It is useful for detecting all types of breast cancer, including invasive ductal and invasive lobular cancer.
Total and added sugar intakes, sugar types and cancer risk: results from the NutriNet-Santé cohort
Authors: Debras C , Chazelas E , Srour B , Kesse-Guyot E , Julia C , Galan P , Hercberg S , Latino-Martel P , Deschasaux M , Touvier M 
Published: October 2020

Abstract

Background
Excessive sugar is now recognized as a key risk factor for several cardiometabolic diseases. In contrast, the associations between sugars and cancer risk in cohort studies have been less investigated, and data is lacking regarding differential effect of sugar types and sources. Experimental data suggest that sugars could play a role in cancer etiology, through obesity but also through inflammatory and oxidative mechanisms and insulin resistance. Our objective was to study the associations between total and added sugar intake and cancer risk, accounting for sugar types and sources.

Methods
101,279 French adults from the NutriNet-Santé prospective cohort study (2009-2019) were included. Sugar intake was assessed using repeated 24h-dietary records, designed to register participants' usual consumption for more than 3,500 food and beverage items. Associations with cancer risk were assessed by multi-adjusted Cox proportional hazard models.

Results
Sugar intake was associated with increased cancer risk (2,503 cases, Hazard Ratio Quartile 4 vs 1=1.17, 95% Confidence Interval 1.00-2.37, P trend=0.02). This association was mainly driven by breast cancer (783 cases, HR Q4 vs Q1=1.51 (1.14-2.00); P trend=0.0007) and remained significant even when weight-gain during follow-up was accounted for. Associations were more specifically observed for added sugars (P trend=0.02), free sugars (P trend=0.007), sucrose (P trend=0.01), and sugars from milk-based desserts (P trend=0.02), from sugary drinks (P trend=0.002), and from dairy products (P trend=0.01).

Conclusions
These results suggest that sugar (especially added sugar), of which intake is increasing in Western countries, may represent a modifiable risk factor for cancer prevention, adding to its well-established effect on dental and cardiometabolic health. These findings provide important and novel insights to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies.

Key messages
In this large-scale prospective cohort of French adults, sugar intake (especially added sugar) was associated with higher cancer risk. These results suggest that (added) sugar may represent a modifiable risk factor for cancer prevention, adding novel insights to current debates on implementing sugar-related public health policies.
A health impact assessment (HIA) on a new motorway bypass in Strasbourg, France
Authors: Christie D , Dardier G , Jabot F , Roué-LeGall A , Cantoreggi N , Mallet Y , Tabbone L , Simos J 
Published: October 2020

Abstract

Issue
In 2018-2019, HIA was carried out on a projected 24-km north-south motorway bypass in a rural area west of Strasbourg, intended to alleviate pressure on a pre-existing motorway that cuts through the city centre. Although transport is a major source of impacts on health, HIA is rarely performed on new road construction projects, globally.

Description
The HIA included the screening, scoping, assessment and recommendations phases. Assessed health determinants were outdoor air quality, noise, mobility/access to health services, road safety, urban planning and the living environment. Methods included a literature review, the AirQ+ air pollution model, cartography and an NVivo analysis of answers to a public enquiry.

Results
Noise was set to increase for 1-4% of the population in the study area, but impacts related to air pollution appeared to be negligible and road safety did not change substantially. Mobility and access to health services were to improve, with strong local differences (inequalities): some areas benefitted from access to the new motorway without being affected by noise or traffic, while for others it was the opposite. Stakeholders who participated in the public enquiry were concerned about the loss of agriculturally and environmentally valuable land, viewed as a collective cultural asset. Those living in the vicinity of the bypass expressed anger at the reduction of the quantity and quality of green areas, which was experienced as an injustice given their choice to live in a rural area. Our recommendations related mainly to the pre-existing urban motorway, where reducing traffic volumes and speeds, as well as diverting trucks onto the new bypass, had the most promising effects on health.

Lessons
Due to its rural localization, the new road had limited health effects through air pollution, which is the focus of many transport-related HIAs. Through the analysis of the public enquiry, the HIA showed that the project generated anger and distress.

Key messages
The substantial investment represented by the new bypass did not solve pre-existing problems related to environmental health but generated new ones linked to social and mental health issues. Many HIAs miss out on valuable qualitative information because interviews or focus groups cannot be carried out with local stakeholders. Secondary analysis of public consultations can fill this gap.
Students as advocates of global health goals: the case of medical education in Germany
Authors: Kreitlow A , Steffens S , Kuhlmann E 
Published: October 2020

Abstract

Background
Germany has started to take on greater responsibility in global health policy. Furthermore, new threats, such as climate change, have increased sensitivity. However, health professionals are not well prepared to respond to the new tasks and the changing needs of the population. Global health is still largely missing from the education and training programmes of the vast majority of professional groups in Germany. This paper aims to illustrate how students can become advocates of global health education and enhance institutional change, when health policy fails to act effectively.

Methods
An elective programme introduced in September 2019 in the undergraduate medical curriculum at Hannover Medical School, Germany, serves as a case study to explore the tools and substance of the programme, as well as the stakeholders involved.

Results
The new global health programme utilises a window of opportunity in the curriculum, which includes a small number of mandatory seminars which students can chose from. It builds on five major pillars: collaboration between students and the programme coordinator and participatory curriculum development; the SDGs as framework and guidance of the curriculum; a multiprofessional and transsectoral teaching team; collaboration with NGOs; strong networks through collaboration with the national German medical students' association. Sustainability remains a major challenge, yet there is now institutional and financial support at Hannover Medical School and the new German National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education also includes global health issues.

Conclusions
Students as advocates for global health can make a difference and enhance institutional change through transsectoral, participatory teaching programmes.
Gender and global health education, what is it about the Global South
Authors: Atobrah D 
Published: October 2020

Abstract

Background
International policy frameworks have strengthened advocacy for gender equality, as agreed in SDG 3. However, gender considerations in research and the related methodological approaches often focus on gender-oriented topics in the global North with little attention on gender perspectives in ostensibly neutral disciplines such as health, and with even less consideration in African societies. The aim is to illustrate how feminist research principles, sensitivity to gender relations and gender performance are cross-cutting and integral in the use of patient-centered methods, ethics and culture.

Methods
Material was taken from an ethnographic study based on in-depth qualitative interviews conducted with cancer patients in Accra, Ghana. Eight cases studies of women diagnosed of breast cancer, ovarian, endometrium or cervical cancer were selected for the present analysis.

Results
In highly gendered societies like Africa health research is shaped by the peculiar ethical considerations on gender and cultural issues. This leads to a situation where female researchers may have favourable opportunities for gathering qualitative material because of gender stereotypes. However, they face gendered expectations of their research participants during data collection periods, and this may provoke adverse reactions, if the researcher does not meet the expectations. Education into patient-centred methods, therefore, must strengthen competencies of health professionals to critically reflect their own gendered realities and confront masculinity and femininity reactions by research participants, while being culturally sensitive and ethical at the same time.

Conclusions
Advocacy for gender approaches in global health education is important but not sufficient. Action is needed to develop a methodological approach sensitive to the gendered conditions of patient-centred research in the Global South.