Suchergebnisse

Background: The global economic crisis has been associated with increased unemployment, reduced health-care spending and adverse health outcomes. Insights into the impact of economic variations on cancer mortality, however, remain limited. Methods: We used multivariate regression analysis to assess how changes in unemployment and public-sector expenditure on health care (PSEH) varied with female breast cancer mortality in the 27 European Union member states from 1990 to 2009. We then determined how the association with unemployment was modified by PSEH. Country-specific differences in infrastructure and demographic structure were controlled for, and 1-, 3-, 5- and 10-year lag analyses were conducted. Several robustness checks were also implemented. Results: Unemployment was associated with an increase in breast cancer mortality [P < 0.0001, coefficient (R) = 0.1829, 95% confidence interval (CI) 0.0978–0.2680]. Lag analysis showed a continued increase in breast cancer mortality at 1, 3, 5 and 10 years after unemployment rises (P < 0.05). Controlling for PSEH removed this association (P = 0.063, R = 0.080, 95% CI −0.004 to 0.163). PSEH increases were associated with significant decreases in breast cancer mortality (P < 0.0001, R = –1.28, 95% CI −1.67 to −0.877). The association between unemployment and breast cancer mortality remained in all robustness checks. Conclusion: Rises in unemployment are associated with significant short- and long-term increases in breast cancer mortality, while increases in PSEH are associated with reductions in breast cancer mortality. Initiatives that bolster employment and maintain total health-care expenditure may help minimize increases in breast cancer mortality during economic crises.

OBJECTIVES Smoking is related to income and education and contributes to social inequality in morbidity and mortality. Socialisation theories focus on one's family of origin as regards acquisition of norms, attitudes and behaviours. Aim of this study is to assess associations of daily smoking with health orientation and academic track in young Swiss men. Further, to assess associations of health orientation and academic track with family healthy lifestyle, parents' cultural capital, and parents' economic capital. METHODS Cross-sectional data were collected during recruitment for compulsory military service in Switzerland during 2010 and 2011. A structural equation model was fitted to a sample of 18- to 25-year-old Swiss men (N = 10,546). RESULTS Smoking in young adults was negatively associated with academic track and health orientation. Smoking was negatively associated with parents' cultural capital through academic track. Smoking was negatively associated with health orientation which in turn was positively associated with a healthy lifestyle in the family of origin. CONCLUSIONS Results suggest two different mechanisms of intergenerational transmissions: first, the family transmission path of health-related dispositions, and secondly, the structural transmission path of educational inequality.

This book offers insights and perspectives from a study of "Cultural Encounters in Intervention Against Violence" (CEINAV) in four EU countries. Seeking a deeper understanding of the underpinnings of intervention practices in Germany, Portugal, Slovenia and the United Kingdom, the team explored variations in institutional structures and traditions of law, policing, and social welfare. Theories of structural inequality and ethics are discussed and translated into practice.

Background: To encourage people to lead healthier lifestyles, governments in many countries publish guidelines for alcohol intake, physical activity (PA), and fruit and vegetable (FV) intake. However, there is a need for better understanding of whether people understand such guidelines, consider them useful, and adhere to them. University students are a group worth of attention because although they are less likely than older adults to exceed UK weekly alcohol intake guidelines or to be inactive, they are also less likely to meet FV consumption targets. Furthermore, because behaviour during youth predicts adult behaviour, it is important to identify influences on healthier behaviour. Methods: An online survey was completed by 559 UK university students. Key outcome variables were knowledge of guidelines, motivation to adhere to them, and adherence to them. Results: 72% adhered to guidelines for alcohol intake, 58% for PA, and 20% for FV intake. Students generally had poor or moderate knowledge of guidelines, perceived them as only moderately useful, and were only moderately motivated to adhere to them. Greater motivation to adhere to guidelines was not significantly related to more accurate knowledge. However, it was related to greater familiarity, and perceiving guidelines as useful and realistic, and greater conscientiousness. Discussion: There is a need to ensure that students understand the UK guidelines for alcohol intake, PA, and FV intake. However, simply increasing knowledge may not lead to greater adherence to the guidelines: there is also a need to focus on improving perceptions of how useful and realistic they are.

BACKGROUND The traditional model of promotion and tenure in the health professions relies heavily on formal scholarship through teaching, research, and service. Institutions consider how much weight to give activities in each of these areas and determine a threshold for advancement. With the emergence of social media, scholars can engage wider audiences in creative ways and have a broader impact. Conventional metrics like the h-index do not account for social media impact. Social media engagement is poorly represented in most curricula vitae (CV) and therefore is undervalued in promotion and tenure reviews. OBJECTIVE The objective was to develop crowdsourced guidelines for documenting social media scholarship. These guidelines aimed to provide a structure for documenting a scholar's general impact on social media, as well as methods of documenting individual social media contributions exemplifying innovation, education, mentorship, advocacy, and dissemination. METHODS To create unifying guidelines, we created a crowdsourced process that capitalized on the strengths of social media and generated a case example of successful use of the medium for academic collaboration. The primary author created a draft of the guidelines and then sought input from users on Twitter via a publicly accessible Google Document. There was no limitation on who could provide input and the work was done in a democratic, collaborative fashion. Contributors edited the draft over a period of 1 week (September 12-18, 2020). The primary and secondary authors then revised the draft to make it more concise. The guidelines and manuscript were then distributed to the contributors for edits and adopted by the group. All contributors were given the opportunity to serve as coauthors on the publication and were told upfront that authorship would depend on whether they were able to document the ways in which they met the 4 International Committee of Medical Journal Editors authorship criteria. RESULTS We developed 2 sets of guidelines: Guidelines for Listing All Social Media Scholarship Under Public Scholarship (in Research/Scholarship Section of CV) and Guidelines for Listing Social Media Scholarship Under Research, Teaching, and Service Sections of CV. Institutions can choose which set fits their existing CV format. CONCLUSIONS With more uniformity, scholars can better represent the full scope and impact of their work. These guidelines are not intended to dictate how individual institutions should weigh social media contributions within promotion and tenure cases. Instead, by providing an initial set of guidelines, we hope to provide scholars and their institutions with a common format and language to document social media scholarship.

Background: On March 23, 2020, the government of the United Kingdom told the British people to stay home, an unprecedented request designed to limit the spread of the COVID-19 virus and stop the National Health Service from being overwhelmed. Methods: This study undertook a cross-sectional design to survey a convenience sample of 681 residents of North London on their social distancing (SD) behaviours, demographics, housing situation, politics, psychology and social support using an online questionnaire. Logistic regression was used to measure the associations between these explanatory factors and non-adherence to all SD rules and intentional non-adherence to SD rules. Results: The vast majority (92.8%) of participants did not adhere to all SD rules and nearly half (48.6%) engaged in intentional non-adherence of rules. The odds of not adhering to all SD rules increased if a participant was not identified as highly vulnerable to COVID-19 [OR = 4.5], had lower control over others' distancing [OR = .724], had lower control over responsibilities for which coming into contact with others was unavoidable [OR = .642], and if SD behaviours were reported after lockdown was first relaxed [OR = .261]. The odds of intentionally not adhering to SD rules increased if a participant had a lower intention to socially distance [OR = .468], had lower control over others' distancing [OR = .829], had a doctoral degree compared to a master's degree [OR = .332], a professional qualification [OR = .307], a bachelor's degree [OR = .361] or work-related qualification [OR = .174], voted for the UK Government compared to not voting for the Government [OR = .461], perceived higher normative pressure from neighbours [OR = 1.121] and had greater support from friends [OR = 1.465]. Conclusions: Non-adherence to all SD rules had a stronger association with vulnerability to COVID-19 and control over SD, whereas intentional non-adherence had a stronger association with intention and anti-social psychological factors. It is recommended that people living in high-risk environments, such as those living in houses of multiple occupancy, should be specially supported when asked to stay at home, and public health messaging should emphasise shared responsibility and public consciousness.

The position presented in this article draws on the professional insights of the authors, reflecting on issues of global political importance in culture and migration mental health. As institutional theory perspectives continue to develop, solutions to complex social problems such as racism require embodied knowledge if the lines of authority and basic occupational routines are to be meaningfully renegotiated. Embodied knowledge is socially situated and self-reflexive and reflects cumulative and marginalized experiences that contribute to a better understanding of institutional racism and the social construction of whiteness. The authors foreground the development of critical consciousness and emotional literacy in order to be more professionally competent in institutional contexts of mental health training, education and practice. To this end, elements of due process, transparency, inclusiveness, community engagement and accountability are at the center of a political and intellectual movement towards epistemological justice to promote antiracism and social justice in culture and migration mental health. The authors define decolonial intersectionality as a clear philosophical vision outlining how best to respond to those at risk of experiencing racism and the associated mental health burdens.

Health in all policies is a key approach to promote health and calls for cooperation between diverse levels of government and different sectors. In this paper, we analyze how a network called 'Healthy Region Plus' in Southern Germany addresses intersectoral cooperation at city and county levels. We aim to analyze the different roles of actors involved in the network based on the promoter model. We conducted two socio-material network mappings based on the Net-map approach by Schiffer and Hauck. The analysis followed three steps: data visualization, descriptive analysis of network properties, and interpretation of findings. Our findings reveal a complex intersectoral cooperation structure, with county and city level clusters, with network members who act as diverse power, expert, process, or relationship promoters. We also identified certain relevant sectors not to be part of the network. We discuss that the success of the network depends on the members' active participation in and their outreach beyond the existing network, between city and county levels, and across sectors to promote health and build health-promoting structures in the region.

Das Projekt "unabhängige Beratungsstelle für Menschen im Freiheitsentzug und ihre Angehörigen" wurde 2017 von humanrights.ch für eine voraussichtlich dreijährige Pilotphase im Kanton Bern ins Leben gerufen und hat zum Ziel und Zweck, Menschen im Freiheitsentzug und ihren Angehörigen Zugang zu einer unabhängigen kompetenten Rechtsberatung zu verschaffen. So werden die Grundrechte dieser marginalisierten sozialen Gruppe gestärkt und die zuständigen Anstaltsleitungen und Behörden im Hinblick auf systemisch bedingte Schwachstellen im Grund- rechtsschutz sensibilisiert. Das Projekt soll zukünftig auf weitere Kantone ausgeweitet werden. Die Evaluation dauerte vom 1. Juni 2019 bis zum 31. Juli 2019 und fragte nach der Einhaltung der Menschenrechte im Freiheitsentzug, dem Bedarf einer unabhängigen Rechtsberatung, der Qualität der Arbeit der Beratungsstelle gemäss der Wahrnehmung verschiedener Anspruchsgruppen und eruierte potentielle Entwicklungsmöglichkeiten.

Durch die Globalisierung werden wir zunehmend mit Problemen konfrontiert, welche Landesgrenzen überschreiten. Auch viele gesundheitspolitische Entscheidungen werden heute auf europäischer Ebene oder unter der Mitarbeit internationaler Organisationen getroffen. In diesem Kapitel betrachten wir Gesundheitsindikatoren sowie Krankheits- und Todesursachen im Hinblick auf das Bevölkerungseinkommen und die Entwicklung in verschiedenen Ländern. Wir analysieren die wichtigsten Faktoren, die die Gesundheit der Menschen in Industrie- und Entwicklungsländern beeinflussen und beschäftigen uns schließlich mit den Strategien und Akteuren, welche die Globale Gesundheit heute prägen.

Durch die Globalisierung werden wir zunehmend mit Problemen konfrontiert, welche Landesgrenzen überschreiten. Auch viele gesundheitspolitische Entscheidungen werden heute auf europäischer Ebene oder unter der Mitarbeit internationaler Organisationen getroffen. In diesem Kapitel betrachten wir Gesundheitsindikatoren sowie Krankheits- und Todesursachen im Hinblick auf das Bevölkerungseinkommen und die Entwicklung in verschiedenen Ländern. Wir analysieren die wichtigsten Faktoren, die die Gesundheit der Menschen in Industrie- und Entwicklungsländern beeinflussen und beschäftigen uns schließlich mit den Strategien und Akteuren, welche die Globale Gesundheit heute prägen. Schweizerische Lernziele: CPH 46 – 48

Les sciences sociales analysent les défis que pose le COVID-19 en les insérant dans les dynamiques de nos sociétés. Avec le recul qui les caractérise, ces sciences sont particulièrement adaptées pour comprendre les dynamiques sociales, économiques et politiques d'une maladie qui, pour certain·es, a les traits du diable, et pour d'autres, ceux d'une banale grippe. Ce livre décrypte comment les individus, les organisations et les communautés font face, souffrent et réagissent au COVID-19. 27 chercheur·ses s'y penchent et proposent un ensemble d'éclairages inédits.

INTRODUCTION Primary ciliary dyskinesia (PCD) is a rare, genetic, multiorgan disease with an estimated prevalence of 1 in 10 000. It affects mainly the upper and lower airways due to impaired mucociliary clearance. Almost all patients have sinonasal or otologic (ear-nose-throat, ENT) problems, although the ENT clinical phenotype may present great variability. Despite that, data on PCD ENT manifestations are scarce and based on small single-centre studies. To date, we know little about the spectrum and severity of PCD ENT disease, its association with lung disease, its course over life and its determinants of prognosis.This study protocol describes the aims and methods of the first prospective, observational, multinational cohort study focusing on ENT disease in patients with PCD. METHODS AND ANALYSIS The ENT prospective international cohort of patients with PCD (EPIC-PCD) is a prospective standardised observational clinical cohort set up as a multinational multicentre study, embedded into routine patient care. It aims to longitudinally characterise ENT disease in patients with PCD and its association with lung disease, and to identify determinants of its prognosis. Patients of all ages, diagnosed with PCD who undergo an ENT clinical assessment at least once a year at one of the participating centres will be invited to participate. Collected data include diagnostic test results, results of ENT examinations, lung function measurements, information on management of ENT disease and patient-reported data on clinical symptoms and health-related quality of life (QoL). Data are collected using the standardised PCD-specific FOLLOW-PCD form and the validated QoL-PCD questionnaire. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Human Research Ethics Committees at all participating centres, based on local legislation. The results of the study will be published in scientific journals, presented at scientific conferences and disseminated to participants and national patient organisations. TRIAL REGISTRATION NCT04611516.

INTRODUCTION Multimorbidity and polypharmacy are important risk factors for drug-related hospital admissions (DRAs). DRAs are often linked to prescribing problems (overprescribing and underprescribing), as well as non-adherence with drug regimens for different reasons. In this trial, we aim to assess whether a structured medication review compared with standard care can reduce DRAs in multimorbid older patients with polypharmacy. METHODS AND ANALYSIS OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people is a European multicentre, cluster randomised, controlled trial. Hospitalised patients ≥70 years with ≥3 chronic medical conditions and concurrent use of ≥5 chronic medications are included in the four participating study centres of Bern (Switzerland), Utrecht (The Netherlands), Brussels (Belgium) and Cork (Ireland). Patients treated by the same prescribing physician constitute a cluster, and clusters are randomised 1:1 to either standard care or Systematic Tool to Reduce Inappropriate Prescribing (STRIP) intervention with the help of a clinical decision support system, the STRIP Assistant. STRIP is a structured method performing customised medication reviews, based on Screening Tool of Older People's Prescriptions/Screening Tool to Alert to Right Treatment criteria to detect potentially inappropriate prescribing. The primary endpoint is any DRA where the main reason or a contributory reason for the patient's admission is caused by overtreatment or undertreatment, and/or inappropriate treatment. Secondary endpoints include number of any hospitalisations, all-cause mortality, number of falls, quality of life, degree of polypharmacy, activities of daily living, patient's drug compliance, the number of significant drug-drug interactions, drug overuse and underuse and potentially inappropriate medication. ETHICS AND DISSEMINATION The local Ethics Committees in Switzerland, Ireland, The Netherlands and Belgium approved this trial protocol. We will publish the results of this trial in a peer-reviewed journal. MAIN FUNDING European Union's Horizon 2020 programme. TRIAL REGISTRATION NUMBER NCT02986425 , SNCTP000002183 , NTR6012, U1111-1181-9400.

This study tries to assess the status of Islam in the context of the Swiss discursive public sphere. Relying on an empirical survey conducted with representatives from fifty Muslim organisations based in the German-speaking part of Switzerland, the study examines the relative position of Muslim organisations in the political public sphere and the role of Islam in public debate from the perspective of the organisations themselves. The empirical findings will be interpreted using two ideal types. The category "public sphere" known from Jürgen Habermas' works will help to determine the social status of the Muslim community in the context of the Swiss public sphere, while the normative concept "public religion", as developed by the sociologist José Casanova in his book Public Religions in the Modern World, will contribute to determine the role of Islam in Swiss public debate.