bluuebunny/crossref_metadata_2025_split huggingface dataset:
Instrumental, structural & discursive power & the regulation of online advertising of unhealthy food
Authors: Carters-White L , Hilton S , Skivington K , Chambers S 
Published: October 2021

Abstract

Background
Examinations of corporate power demonstrate how Unhealthy Commodity Industries (UCIs) exert influence on the public and policymakers. For example, the High in Fat Sugar and Salt (HFSS) product industry exploit online environments to market their products to young people as a form of discursive power, and regulating this marketing can limit the power of those industries and is recognised as an important policy response. Here we address the gap in consideration of stakeholders' views of regulation of online advertising of HFSS products to young people to limit industry power.

Methods
We undertook primary analysis of 8 focus groups of parents, 11 stakeholder interviews and secondary analysis of 15 focus groups of young people (aged 12 and 15 years-of-age) in various community settings, with 5 individual interviews over the telephone. Focus group participants were recruited from a range of socioeconomic areas following the Scottish Index of Multiple Deprivation quintiles. Stakeholders were recruited from civil society organisations, government bodies and industry. Analysis employed Fuchs and Lederer's (2007) framework on instrumental, structural and discursive power.

Results
Stakeholders' views on the power of HFSS product industry appeared to predicate their views on regulation as an appropriate policy response. The majority of participants viewed regulation as a means to increase young people's and parents' autonomy over young people's diets by addressing the problematic power dynamic with industry at a policy level, yet concern remained about the adverse impact of regulation on individual autonomy.

Conclusions
Power is an important consideration when examining acceptability of To increase public support for regulation, it may be beneficial to emphasise the empowering effects of policy proposals. Advocates should shift their framing of regulation from focusing on restricting industry, to focusing on empowering the public.

Key messages
Views on power appear important when considering public acceptability of regulatory policy. Understanding views on power may improve public health messaging on policy interventions.
Managers’ sick-leave recommendations for employees with common mental disorders – a vignette study
Authors: Hultqvist J , Hensing G , Stansfeld S , Bertilsson M 
Published: October 2021

Abstract

Background
To better understand the initial phases of employee sickness absence due to common mental disorders (CMD), this study explores managers' recommendation for sick leave to a CMD-labelled video vignette case. The aim was to investigate the associations between sick leave recommendation and 1) managers' experience of persons with CMD, and 2) managers' previous recommendation of sick leave for employees with CMD, and 3) managers' attitudes toward employees with CMD.

Methods
An online survey was sent in 2017 to 4,737 Swedish managers, aged 20-65 years (71% participated, n = 3,358). The survey included two randomized video vignettes, one female and one male. The vignettes were two minutes long. For aims 1 and 3 a study sample consisting of 2714 managers were used. For the second aim a sub-sample (n = 1740) was used due to the design of the survey questions.

Results
The bi-variate analysis showed that personal experience of CMD was associated with managers' recommendation of employee sick leave. In the adjusted regression model, it became insignificant (p = 0.056). Having previous experience of recommending sick leave to one employee (OR 3.7, 95% C.I. 2.90-4.73), and to several employees (OR 7.1, 95% C.I. 4.27-11.82), were associated with recommending sick leave, adjusted for gender, level of education, years of managerial experience, and having had management training on CMDs. Finally, there was no significant association (p = 0.071) between negative attitudes towards employee depression and managers' recommendation of employee sick leave to the vignette case.

Conclusions
The likelihood of a manager recommending sick leave after watching a CMD-labelled video vignette was higher if the manager had previously experienced this situation in real life. We consider this study being important as a first study looking into managers' attitudes and personal experience and recommendations of sick leave.

Key messages
The odds for recommending sick leave to a video vignette case was higher if managers had this experience. This study highlights the importance of including managerial behaviors to understand the sick leave process for employees with CMD.
Sociocultural factors of cervical cancer screening uptake among migrant women: a mixed methods study
Authors: Marques P , Gama A , Geraldes M , Silva J , Vaccari N , Dias S 
Published: October 2021

Abstract

Cervical cancer has a high mortality in Europe despite being preventable by cervical cancer screening (CCS). Migrant women have a lower CCS attendance compared to non-migrants. This study aims to describe CCS uptake among migrant women in Portugal and explore sociocultural influences. Within a mixed-methods approach, an online survey and focus group discussions (FGs) were conducted. The survey included 655 migrant women and collected data on sociodemographics, attendance and attitudes toward CCS. Four FGs with 12 healthcare workers and a FG with 5 community workers were conducted exploring perceptions on CCS attendance and barriers among migrant women. Quantitative data was analyzed using descriptive analysis and Chi-Square test and qualitative data through content analysis. Survey data shows that 24.9% of women never had CCS or had it over 5 years ago, more Asian and African women (51.3% and 36.7%, respectively) (p &lt; 0.001). Non-attenders reported significantly more often embarrassment towards CCS (21.7% vs. 18.8% of CCS attenders, p = 0.002) and being unaware of their risk of cancer and the relevance of CCS (28.8% vs. 12.5%, p &lt; 0.001). Around 24% of non-attenders reported concern with having a consultation with a male doctor. For FGs participants, CCS is a taboo in some communities, particularly African, Asian and Muslim. Lack of information about CCS along with feelings of embarrassment and discomfort related to pap smear and with being seen by a male doctor were referred as reasons for avoidance of CCS. Participants also stated that some women have low autonomy and often their husbands have a key role in deciding whether they should attend CCS. Lack of a preventive mindset was also stated as reason for low CCS attendance. The sociocultural background can influence migrant women's attendance to CCS. A culturally grounded approach is needed to provide tailored information on CCS and to create opportunities to engage migrant communities on CCS and improve their uptake.

Key messages
Lack of information, embarrassment and low autonomy hinder some migrant women’s attendance to CCS. The sociocultural influences on CCS uptake call for a culturally grounded approach to provide tailored information and engage migrant communities on CCS.
Interventions aimed at improving health care equity for d/Deaf patients: a systematic review
Authors: Morisod K , Malebranche M , Marti J , Spycher J , Grazioli V , Bodenmann P 
Published: October 2021

Abstract

Background
d/Deaf people suffer from inequitable access to care and health information, which results in worse health literacy and poorer mental and physical health compared to hearing populations. Various interventions aimed at improving health equity for d/Deaf people exist in the scientific literature but have to be systematically analysed. The purpose of this systematic literature review was to obtain a global overview of what we know about these interventions.

Methods
Medline Ovid SP, Embase, CINAHL EBSCO, PsycINFO Ovid SP, Central - Cochrane Library Wiley and Web of Science were searched for relevant studies on access to health care, interventions and health education for d/Deaf people following PRISMA-equity guidelines. The outcomes of interest were interventions aimed at achieving equitable care access to health information for d/Deaf people.

Results
Forty-eight studies were analysed. Four main categories of interventions emerged: 1) interventions addressing direct clinical care, 2) health technology-based interventions, 3) interventions focused on patient education, and 4) interventions focused on health care provider education. Among them, access to sign language interpretation or to culturally and linguistically adapted means of communication, use of communication media such as sign language video for the dissemination of medical information, and increasing use of technology (telemedicine, videoconferencing) were effective to strengthen equity in the care of d/Deaf people. Moreover, involving d/Deaf individuals in the conceptualization, creation, implementation and evaluation of interventions seemed to be imperative.

Conclusions
A multi-pronged approach, using a combination of interventions that improve health literacy among d/Deaf patients and promote health care providers' awareness of communication barriers and cultural sensitivity show promise in achieving more equitable care for d/Deaf patients, but more widespread research is needed.

Key messages
The scientific literature has identified and analysed many tools for improving health care equity for d/Deaf people, but their implementation is lacking. The involvement of d/Deaf people in research and implementation processes is crucial for the development of appropriate interventions.
Improving access to health care for asylum seekers in Belgium: a national stakeholder consultation
Authors: Dauvrin M , Detollenaere J , De Laet C , Roberfroid D , Vinck I 
Published: October 2021

Abstract

Background
All asylum seekers (AS) in Belgium are entitled to health care coverage while awaiting a decision regarding a refugee status. However, in practice, numerous public institutions oversee the governance, the distribution of funding and the practical organisation of health care. As a result, AS have currently no guarantee of receiving the health care they need.

Methods
In 2017-2019, a 5-step approach was used. Firstly, 3 data sources were combined to identify major problems and possible options to solve it (literature, interviews, and existing databases). Secondly, these options were submitted to a large panel of Belgian experts, field workers and policymakers through an online survey (n = 171). Survey results and non-consensual results were discussed in a 3rd step with 35 field workers, experts, and policymakers. In a 4 step, individual interviews were conducted with stakeholders likely to be affected by the different options. In a final step, all stakeholders attended a final meeting following by an online consultation to validate the final options.

Results
Stakeholders agreed on 3 basic principles that should sustain a reform of health care for AS: respecting the current legal framework, ensuring equity among all AS and supporting administrative simplification. Three different models of access emerged with 2 options regarding the governance of health care for AS and 3 options for the distribution of the funding. Each model was assessed regarding its impact on the identified problems and the respect of the 3 basic principles. Besides, 8 quick-wins at the system level and 6 at the organisation level were proposed.

Conclusions
Despite the involvement of the policymakers, no consensus was found at the end of the research. Final decision will then remain in the hands of the policymakers.

Key messages
In Belgium, access to health care for asylum seekers is impeded by the numerous public institutions involved. Equity between asylum seekers should be guaranteed by an appropriate governance and an adequate distribution of funding.
Reproductive health services use by the Roma minority women in Romania
Authors: Nanu M , Stativa E , Moldovanu F , Nanu I 
Published: October 2021

Abstract

Backgound
In Romania Roma women are vulnerable to pregnancy-related events, unwanted pregnancies, stillbirth, abortion and cervical cancer. This paper aims to analysis the use of reproductive health services, family planning, prenatal care and screening for cervical cancer by Roma women.

Methods
A secondary analysis was performed on the data of the Reproductive Health Survey in Romania 2016, of a subsample of 314 Roma women, aged 15-44 years.

Results
2/3 of Roma women had their first pregnancy in adolescence, 66.9% between 15-19 and 8.4% under 15 years of age. 65.4% Roma adolescent girls had their first child at 15-19 years, and 2.8% at ages under 15 years. During pregnancy, 24.1% of Roma women do not use prenatal care services, three times more than the women from the reference population (7.1%) (p &lt; 0.01). 73% of Roma women have never benefited from cervical cancer screening compared to 42.7% in the general fertile female population. 46, 7% of Roma women use any type of contraceptive method and 38.1% modern methods, a closed prevalence of contraception in the general population of fertile women (48.4% of any method and 38.7% modern methods)

Conclusions
Roma women have their first pregnancy in adolescence. There are inequalities in the use of preventive services for prenatal care and cervical cancer screening of the Roma female population compared to the reference female population in Romania. Public health policies should include specific active measures for Roma women to improve their access to preventive services. In order to prevent unwanted pregnancies, public health policies in Romania should include family planning measures addressed towards all women, but using methods culturally adapted to the Roma population.

Key messages
There are inequalities in sexual reproductive health services use of Roma minories women I Romania. Services and active preventive mesures should be adressed to Roma populationtion.
Unravelling data for rapid evidence-based response to COVID-19: the unCoVer project
Authors: Pires Sara 
Published: October 2021

Abstract
The unprecedented health system's response to the COVID-19 pandemic is generating a multitude of data that has enormous potential for informing policy and research at the national and international levels. The unCoVer project is a functional network of 29 partners that was established to bring together European and international expertise to monitor, identify, and facilitate the access and utilization of COVID-19 patient's data, to identify knowledge gaps, underrepresented populations, and proactively seek synergies with complementary clinical databases. unCoVer's members are capable of collecting and utilizing data derived from the response and provision of care to COVID-19 patients by health systems across Europe and internationally. These real world data comprise information from electronic medical records from front line hospitals, national surveillance data, and registries. Thus far, they integrate information from over 300,000 COVID-19 patients, which is anticipated to increase as databases are being continuously updated. These data may inform future burden of disease assessments, by gaining a deeper understanding on the disease model and variations among heterogeneous groups of patients, including COVID-19 manifestations in vulnerable population subgroups, and shedding light into post-COVID conditions that may add to the disability estimations. A federated learning platform integrating the characterization of ethical and data protection components from each dataset will be used for pooled analysis. unCoVer will develop a model for the use of dissimilar data sources capable of streamlining ethical and legal aspects for the correct use of data, complying with local and international regulations, and bringing together expertise on the use of advanced computational, epidemiological and biostatistical methods to handle heterogeneous, and multi-layered information aiming for significant medical and public health impact.
Strengthening community self-help clubs for health and wellbeing
Authors: Koot J , Nguyen Van M 
Published: October 2021

Abstract
The SUNI-SEA project invests in community organisations in Vietnam, Myanmar and Indonesia. In Vietnam and Myanmar these organisations are called Intergenerational Self-Help Clubs and aim at strengthening the social cohesion in communities. The organisations stimulate mutual support of members in health, wellbeing and socio-economic sustainability. The SUNI-SEA project analysed relevant factors contributing to increase of self-reported health and wellbeing in the community groups. First of all, there are personal factors of motivation and perceived benefits, whereby members make a strong link between health and wellbeing. Feeling part of a group of like-minded persons is important for participation in group activities promoting health. The social benefit of jointly cooking or performing physical exercises is an important motivation. For many participants, improving health is a natural spin-off of mutual support, rather than a primary goal. Secondly, strong community organisations contribute to increased participation in health activities. When there is a continuous offer of health screening, health promotion activities and welfare activities, participation by members remains constantly high, with very low dropout. Investing in leadership skills, organisational strengthening and communication, pays off for achieving sustainable improvement of health in communities.
Analysis of the impact of heat waves on daily mortality in urban and rural areas in Madrid
Authors: López-Bueno JA , Navas-Matín MA , Linares C , Mirón IJ , Luna MY , Sánchez-Martínez G , Culqui D , Díaz J 
Published: October 2021

Abstract

Backgraund
The objective of this study was to analyze and compare the effect of high temperatures on daily mortality in the urban and rural populations in Madrid.

Methods
Data were analyzed from municipalities in Madrid with a population of over 10,000 inhabitants during the period from January 1, 2000 to December 31, 2013. Four groups were generated: Urban Metropolitan Center, Rural Northern Mountains, Rural Center, and Southern Rural. The dependent variable used was the rate of daily mortality due to natural causes per million inhabitants (CIE-X: A00- R99) between the months of June and September for the period. The primary independent variable was maximum daily temperature. Social and demographic “context variables” were included: population &gt;64 years of age (%), deprivation index and housing indicators. The analysis was carried out in three phases: 1) determination of the threshold definition temperature of a heat wave (Tthresold) for each study group; 2) determination of relative risks (RR) attributable to heat for each group using Poisson linear regression (GLM), and 3) calculation of odds ratios (OR) using binomial family GLM for the frequency of the appearance of heat waves associated with context variables.

Results
The resulting percentiles (for the series of maximum daily temperatures for the summer months) corresponding to Tthreshold were: 74th percentile for Urban Metropolitan Center, 76th percentile for Southern Rural, 83rd for Rural Northern Mountains and 98th percentile for Center Rural (98). Greater vulnerability was found for the first two. In terms of context variables that explained the appearance of heat waves, deprivation index level, population &gt;64 years of age and living in the metropolitan area were found to be risk factors.

Conclusions
Rural and urban areas behaved differently, and socioeconomic inequality and the composition of the population over age 64 were found to best explain the vulnerability of the Rural Center and Southern Rural zones.

Key messages
Heat waves affect urban and rural areas differently. So results and conclusions from urban areas should not be extrapolated to rural population. Socioeconomic status and ageing are important variables which explain the different behavior of heat waves in different areas.
Childhood consumption of ultra-processed foods and adiposity trajectories: a UK birth cohort study
Authors: Chang K , Khandpur N , Neri D , Touvier M , Huybrechts I , Millett C , Vamos EP 
Published: October 2021

Abstract

Background
Worldwide consumption of ultra-processed foods (UPFs) is continued to rise. Growing evidence has linked higher consumption with elevated risks of obesity and non-communicable diseases in adults. However, the influence of UPFs on long-term adiposity trajectories have not been evaluated in children.

Methods
Prospective birth cohort data were obtained from the Avon Longitudinal Study of Parents and Children. English children with baseline dietary intakes from 3-day food diaries and repeated adiposity measures were followed up from ages 7-24 years. Outcomes included body mass index (BMI), weight, waist circumference (WC), fat mass index (FMI) and body fat percentage. UPFs were identified using the NOVA food classification. Child's consumption of UPFs was derived as a percentage of its weight contribution (gram per day) in the total diet and categorised into quintiles. Longitudinal associations were assessed using linear growth curve models and adjusted for study covariates.

Results
Of the 9025 children followed up over a median (IQR) of 10.2 (5.2-16.4) years. Trajectories of BMI, FMI, weight and WC increased by an additional 0.06 (95% CI, 0.04-0.08) kg/m2, 0.03 (0.01-0.05) kg/m2, 0.20 (0.11-0.28) kg and 0.17 (0.11-0.22) cm per year among those in the highest (vs. lowest) quintile of UPF consumption. Evidence of dose-response relationships were consistently observed with those in the two highest quintiles of UPF consumption showing significantly more rapid progression of BMI, weight, and WC.

Conclusions
Radical and effective public health actions that reduce children's exposure and consumption of UPFs are urgently needed to address the obesity epidemic in England and internationally.
Funding: CM and EV are funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Grant Reference Number PD-SPH-2015. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Key messages
Children with highest (vs. lowest) quintile of ultra-processed food consumption had more rapid regression of BMI, FMI, weight and waist circumference from ages 7-24 years. Dose-response relationships were consistently observed in the two highest quintile of ultra-processed food consumption showing more rapid progression of BMI, weight and waist circumference.
What health systems do? Functions as a starting point to assess health systems performance
Authors: Papanicolas Irini 
Published: October 2021

Abstract
Health system assessment (HSA) tools are often built around static health system building blocks, which lead to largely descriptive narrative and lack of linkages to health system outcomes. The development of a common framework that would also focus on performance outcomes is long overdue. We analysed the key HSA frameworks and tools based on them, with the purpose of identifying a common approach that would allow to link health system components to specific outcomes. The presentation will focus on using the health system functions as the basis of conducting the performance assessment. In a second step, the presentation will elaborate on the intermediate and final health system goals as part of the HSPA framework. It will explain their links to the four functions and thus, discuss their relevance for performance assessment.