Structural Interventions Research Articles

Publicly expressed climate scepticism is greatest in regions with high CO2 emissions

We analysed a recently released corpus of climate-related tweets to examine the macro-level factors associated with public declarations of climate change scepticism. Analyses of over 2 million geo-located tweets in the U.S. showed that climate scepticism – and the aggressiveness of climate-related tweets – was greater in states with higher per capita carbon emissions. This pattern remained significant after controlling for political conservatism, GDP per capita, education, and gender, and was replicated across 126 nations from around the world. The findings are consistent with a vested interest hypothesis—misinformation around climate change is most likely to be distributed in regions where there is high fossil fuel reliance, and where the economic stakes of acknowledging climate change are high. Understanding the macro-level patterns that are implicated in climate scepticism can help inform structural interventions for those seeking a low-carbon future.

Enhancing Seismic Performance: A Comprehensive Study on Masonry and Reinforced Concrete Structures Considering Soil Properties and Environmental Impact Assessment

Approximately 20,000 people are killed annually on average by building and infrastructure collapses and failures caused by seismic activities. In earlier times, seismic design codes and specifications set minimal requirements for life safety performance levels. Earthquakes can be thought of as recurring events in seismically active areas, with severity states ranging from serviceability to ultimate levels. Buildings designed in accordance with site-specific response spectra, which take into account soil properties based on ground motion amplification data, are better at withstanding such forces and serving their design purposes. This study aims to investigate the site response of reinforced and masonry buildings, considering the effect of soil properties based on the amplification of ground motion data, and to compare the life cycle assessment of the buildings under consideration based on the design and the site-specific response spectrum. In terms of soil properties and site-specific response spectra, STRATA is used to determine the site-specific response for the considered locations for a return period of 475 years for 100 realizations based on the randomization of site properties. For structural analysis, AxisVM software, which is a compatible finite element analysis, is used for building design and analysis, generating comparative results based on the design- and site-specific spectra. To determine and identify potential failures in the model, response spectra were applied to understand the difference in horizontal deflection in two different instances (for elastic design- and site-specific spectra). After building design and analysis is performed, a life cycle analysis in terms of environmental impact assesments using OpenLCA and IdematLightLCA is done. This is done to ascertain the additional expenses in terms of ecocosts and carbon footprints on some failed elements in the structure which are required to make the buildings more resilient when the site-specific response spectrum is applied and to compare the potential economic losses that may occur based on ecological costs. The study presents a comprehensive investigation into the seismic response of masonry and reinforced concrete buildings in Győr, Hungary, incorporating advanced geophysical techniques like multichannel surface wave (MASW) and structural analysis software, AxisVM. Additionally, tailored retrofitting strategies are explored to enhance structural resilience in seismic-prone regions. Significant ground amplifications in soil properties across different profiles are revealed, emphasizing the effectiveness of these strategies in reducing structural deflection and improving resilience. Highlights of the results are observed where the site-specific response spectra are higher than the EC8 design response spectrum. Furthermore, the research underscores the substantial environmental impact, considering both ecocosts and CO2 emissions associated with retrofitting measures, highlighting the importance of sustainable structural interventions in mitigating seismic risks.

Historical, Architectural, and Structural Virtual Tour for Conservation and Maintenance of Architectural Heritage

ABSTRACT The Virtual Tour (VT) represents a key tool used in valorising and disseminating the historical and cultural value of built heritage. Basically, it has potential in supporting interdisciplinary technical activities associated with the historical and architectural aspects related to documentation and conservation. This paper defines the methodological lines into expanding the potentialities of the VT in the framework of a rational technical management and maintenance of historical assets from the Authorities. Thus, in addition to basic information related to historical and architectonical aspects, engineering technical data collected during the knowledge path recommended by relevant National and International codes, dealing with static and seismic performance assessment and the conceptual design of structural interventions, have been included in the VT. The designed STRAINS-VT (hiSToRical, ArchItectural aNd Structural–Virtual Tour) is conceived as a dynamic approach supporting the knowledge and monitoring of valuable assets in time, being open to updates and integration. Benefits associated with the application of the proposed STRAINS-VT have been investigated referring to a real architectural heritage building located in Abruzzi Region (Italy). Research outcomes showed that the knowledge process, which goes from the digital integrated survey and the in-situ structural characterization of materials and components to the analysis and design of structural interventions, can be profitably incorporated within the VT. Particularly, the STRAINS-VT operational framework represents an accessible and easy interpretable informative hub that support technical Authorities having in charge the conservation, maintenance, and restoration of valuable assets in the decision-making, validation, and commissioning of strengthening and maintenance works.

Institutional pathways to psychosis for Indigenous Māori: A qualitative exploration of experiences

BackgroundInequities in the incidence and outcomes of first episode psychosis (FEP) for Indigenous peoples are impacted by multiple institutional systems. This study examines Indigenous experiences of these systems to gain an understanding of how to improve institutional responses to FEP inequity. MethodsCritical race theory informed the methods used. Twenty-three participants participated in four focus group interviews, and thirteen individual interviews, including nine Māori youth and young adults with FEP, ten family members, and four Māori health professionals. Participants were asked about lifetime experiences of institutions (health, social, and criminal-justice). An adapted WHO framework for addressing mental health inequities was used to organize and analyse the first round of structural coding, followed by descriptive and pattern coding. ResultsTwo themes were identified. The first theme signposted opportunities for institutional intervention. Participants critique being processed quickly through institutions that are driven by socio-political agendas, namely perceived risk, threat or crisis. Subsequently, opportunities for meaningful intervention were missed. The second theme identified scope for family orientated responses across sectors. Participants described short-term social interventions and institutional structures that focused on individuals rather than families, emphasizing the need to broaden cross-sector scope to structural interventions for families. DiscussionThe findings highlight institutional responses are focused on organisational drivers and downstream issues, that fail to address the fabric of the family social-environmental conditions that maintain Indigenous exposure to psychosis risk and poor outcomes. A pathway to equity would require a shared framework of social responsibility across sectors, that targets structural factors responsive to Indigenous family needs.

Protocol of the study: Multilevel community-based mental health intervention to address structural inequities and adverse disparate consequences of COVID-19 pandemic on Latinx Immigrants and African refugees.

The NIMH-funded Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees study aims to advance the science of multilevel interventions to reduce the disparate, adverse mental health, behavioral, and socioeconomic consequences of the COVID-19 pandemic that are a result of complex interactions between underlying structural inequities and barriers to health care. The study tests three nested levels of intervention: 1) an efficacious 4-month advocacy and mutual learning model (Refugee and Immigrant Well-being Project, RIWP); 2) engagement with community-based organizations (CBOs); and 3) structural policy changes enacted in response to the pandemic. This community-based participatory research (CBPR) study builds on long-standing collaboration with five CBOs. By including 240 Latinx immigrants and 60 African refugees recruited from CBO partners who are randomly assigned to treatment-as-usual CBO involvement or the RIWP intervention and a comparison group comprised of a random sample of 300 Latinx immigrants, this mixed methods longitudinal waitlist control group design study with seven time points over 36 months tests the effectiveness of the RIWP intervention and engagement with CBOs to reduce psychological distress, daily stressors, and economic precarity and increase protective factors (social support, access to resources, English proficiency, cultural connectedness). The study also tests the ability of the RIWP intervention and engagement with CBOs to increase access to the direct benefits of structural interventions. This paper reports on the theoretical basis, design, qualitative and quantitative analysis plan, and power for the study.

Access to and interest in human milk research opportunities among Black pregnant and postpartum people.

Concerns exist regarding biomedical research participation in marginalized and historically disadvantaged communities. The purpose of this study was to understand critical barriers to participation in human milk research from the perspective of Black pregnant and postpartum people. A national sample of Black pregnant and postpartum people (n = 104) was recruited to complete a cross-sectional online survey informed by the Life Course Perspective. Survey questions assessed research experiences and preferences, particularly related to human milk research, knowledge of historical events/policies targeting Black communities, and demographic characteristics. A socio-economic composite score was calculated as an indicator of socio-economic advantage. Survey data were summarized descriptively and potential correlates of research engagement were evaluated. Most (69%, n = 71) respondents reported previous participation in a research study, yet only 8 (8%) reported ever being asked to participate in a breastfeeding/chestfeeding or human milk study, and one respondent was unsure. Despite so few having been asked, 59% (n = 61) of respondents indicated they would donate breast/human milk to research if asked. Respondent characteristics associated with prior research participation included having greater socio-economic advantage (p = 0.027) and greater knowledge of discriminatory historical events/policies (p < 0.001). In contrast, the only respondent characteristic associated with willingness to donate human milk to research was younger age (p = 0.002). Our findings suggest that Black pregnant and postpartum people are interested in biomedical research, specifically human milk and lactation research. However, greater intentionality and targeted recruitment of this underrepresented population is needed to increase diversity among human milk and lactation study samples. Structural and community-based interventions, informed by community members, are needed to address concerns and improve participant engagement.

Interventions for cold homes: a rapid review of the health impacts.

Cold homes are associated with an increased risk of adverse health outcomes for older people. To mitigate this risk, homes need to be heated to an appropriate temperature. This review aims to identify interventions designed to improve heating and temperatures within homes and summarize its impact on health, health service utilization and cost effectiveness. A rapid review was conducted. Studies assessing the effects of structural, financial, or behavioural interventions designed to improve home temperatures of residents aged 18+ years were eligible. Searches were carried out in four databases. A search for grey literature, and backward and forward citation searching were performed. Data were summarized in a narrative synthesis and mapped using EPPI-Reviewer and EPPI-Mapper software. Eighteen studies reported across 19 publications were included. Structural interventions were associated with better mental health and quality of life, a reduction in health service utilization, and improvements in satisfaction with internal home temperature, social interactions and financial difficulties. The impact on physical health outcomes varied by age, gender and long-term conditions. Evidence about the impact of behavioural interventions was inconsistent. Structural improvements to increase home temperatures may offer the potential to improve some aspects of health. However, the impact on physical health, including which groups are most likely to benefit, is unclear. Key gaps include the lack of evidence about the impact of financial interventions, and the impact of all types of interventions, on quality of life, mortality and costs.

Combined Motivational Interviewing and Ecological Momentary Intervention to Reduce Hazardous Alcohol Use Among Sexual Minority Cisgender Men and Transgender Individuals: Protocol for a Randomized Controlled Trial.

Sexual minority cisgender men and transgender (SMMT) individuals, particularly emerging adults (aged 18-34 years), often report hazardous drinking. Given that alcohol use increases the likelihood of HIV risk behaviors, and HIV disproportionately affects SMMT individuals, there is a need to test interventions that reduce hazardous alcohol use and subsequent HIV risk behaviors among this population. Ecological momentary interventions (EMIs), which use mobile phones to deliver risk reduction messages based on current location and behaviors, can help to address triggers that lead to drinking in real time. This study will test an EMI that uses motivational interviewing (MI), smartphone surveys, mobile breathalyzers, and location tracking to provide real-time messaging that addresses triggers for drinking when SMMT individuals visit locations associated with hazardous alcohol use. In addition, the intervention will deliver harm reduction messaging if individuals report engaging in alcohol use. We will conduct a 3-arm randomized controlled trial (N=405 HIV-negative SMMT individuals; n=135, 33% per arm) comparing the following conditions: (1) Tracking and Reducing Alcohol Consumption (a smartphone-delivered 4-session MI intervention), (2) Tracking and Reducing Alcohol Consumption and Environmental Risk (an EMI combining MI with real-time messaging based on geographic locations that are triggers to drinking), and (3) a smartphone-based alcohol monitoring-only control group. Breathalyzer results and daily self-reports will be used to assess the primary and secondary outcomes of drinking days, drinks per drinking day, binge drinking episodes, and HIV risk behaviors. Additional assessments at baseline, 3 months, 6 months, and 9 months will evaluate exploratory long-term outcomes. The study is part of a 5-year research project funded in August 2022 by the National Institute on Alcohol Abuse and Alcoholism. The first 1.5 years of the study will be dedicated to planning and development activities, including formative research, app design and testing, and message design and testing. The subsequent 3.5 years will see the study complete participant recruitment, data collection, analyses, report writing, and dissemination. We expect to complete all study data collection in or before January 2027. This study will provide novel evidence about the relative efficacy of using a smartphone-delivered MI intervention and real-time messaging to address triggers for hazardous alcohol use and sexual risk behaviors. The EMI approach, which incorporates location-based preventive messaging and behavior surveys, may help to better understand the complexity of daily stressors among SMMT individuals and their impact on hazardous alcohol use and HIV risk behaviors. The tailoring of this intervention toward SMMT individuals helps to address their underrepresentation in existing alcohol use research and will be promising for informing where structural alcohol use prevention and treatment interventions are needed to support SMMT individuals. ClinicalTrials.gov NCT05576350; https://www.clinicaltrials.gov/study/NCT05576350. PRR1-10.2196/55166.

Methods and Tools to Analyse and Mitigate the Seismic and Flood Risks in Inland Areas: A Case Study in the Campania Region (Southern Italy)

The abandonment of inland areas has become a major demographical challenge, causing a condition of local fragility in terms of spatial marginalization. To deal with this issue in Italy, a number of policy actions have been implemented over the time, namely the National Strategy for Inland Areas, established a decade ago, and more recently the Next Generation EU (NGEU) to foster local economic recovery and employment. In this context, RI.P.R.O.VA.RE., a project funded by the former Italian Ministry of the Environment and Protection of Land and Sea (MATTM), was aimed at strengthening the resilience features of communities and territories, focusing on areas within the Matese and Ufita in the Campania region and the Medio Agri in the Basilicata region (southern Italy). Besides the ability to respond to different pressure factors (e.g., of demographic and economic origin), the project also addressed issues concerning seismic and flood risks. This paper synthesizes the methods and tools provided for their analysis and mitigation as a prerequisite for regenerating inland areas. After presenting the developed methods and tools, the results obtained for the Matese study area are presented and discussed. While, on the one hand, the retrieved risk zoning maps allow individuating those municipalities requiring priority structural interventions, on the other hand, the latter are properly individuated based on the peculiar characteristics of urban fabrics.

Impact of Lifestyle Medicine Interventions on the Management of Systemic Hypertension in Primary Care: A Canadian Randomized Controlled Trial

The study aimed to evaluate the feasibility of implementing lifestyle interventions in primary care settings with hypertensive patients and their effect on blood pressure, body composition, cardiometabolic markers, and antihypertensive drug use. Sixty participants diagnosed with stage 1 hypertension were randomly assigned to 4 groups: (1) Standard medical care (control), (2) Physical activity protocol, (3) Dietary Approach to Stop Hypertension (DASH) diet, and (4) Combination of physical activity protocol and DASH diet. Participants received counseling from family physicians, nurses, kinesiologists, and registered dietitians. Various assessments were conducted before (T0) and after (T6) the interventions, including 24-h ambulatory blood pressure monitoring, blood and urine tests, anthropometric measurements, computed tomography to measure adipose tissue, submaximal exercise test to estimate maximal oxygen consumption and health questionnaires. Fifty-one (51) participants (51/57, 89%) completed the program. All interventions reduced blood pressure indices between T0 and T6, except the combined interventions group. Body composition and cardiometabolic parameters were improved in all groups, except for the control group. In total, 28% of participants (7/23) reduced or stopped their antihypertensive medications at T6. The results suggest that structured lifestyle interventions are feasible in primary care and improve blood pressure and cardiometabolic parameters in patients with stage 1 hypertension.

Family systemic therapy: intervention in autism spectrum disorder

IntroductionAutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by communication impairments and difficulties in social interaction. These impairments can affect relationships with family members, increase stress and frustration for both the patient and family members, and contribute to behavioral disturbances in these patients. They are frequently associated with high rates of psychiatric comorbidity.ObjectivesGiven the impact of this disorder on the family unit, we set out to assess the clinical effectiveness of systemic family therapy, its influence on improving communication and coping with this disorder, strengthening relationships and mental health in these patients and their families.MethodsA literature review was performed by searching for articles in Pubmed on May 24, 2023, focusing the terminology used on “Autism Spectrum Disorder” and “Systemic Family Therapy”. The search was limited to full text articles in English and Spanish, published in the last 10 years.ResultsSeveral authors have stated that systemic family therapy could be beneficial:-Providing education.-Reporting additional educational resources.-Focusing sessions on improving social and communication skills, mood and coping behaviors.-Providing therapy to all family members to cope with this disorder and what it implies. It will be very important that the patient with ASD understands his condition and can receive support from his family, working with siblings on the bonding and coping with this condition.-Contributing to facilitate mourning the loss of the condition of “neurotypical” person, exploring emotions, feelings and belief systems, valuing the social and cultural context of the family. ConclusionsReviewing a variety of literature on this therapeutic approach, the authors concluded that “strategic, narrative and structural interventions can be applied from multiple approaches, especially suited to the challenges often faced by patients with ASD and their families”. Therapeutic work needs to involve different family members at different times. Therapeutic conversations will consider the child, the family and the family unit in context. Studies so far have not been able to establish whether particular systemic approaches have more favorable outcomes than others, which warrants further research.Disclosure of InterestNone Declared

Prognostic significance of echocardiographic deformation imaging in adult congenital heart disease.

Due to medical and surgical advancements, the population of adult patients with congenital heart disease (ACHD) is growing. Despite successful therapy, ACHD patients face structural sequalae, placing them at increased risk for heart failure and arrhythmias. Left and right ventricular function are important predictors for adverse clinical outcomes. In acquired heart disease it has been shown that echocardiographic deformation imaging is of superior prognostic value as compared to conventional parameters as ejection fraction. However, in adult congenital heart disease, the clinical significance of deformation imaging has not been systematically assessed and remains unclear. According to the Preferred Reporting Items for Systematic Reviews checklist, this systematic review included studies that reported on the prognostic value of echocardiographic left and/or right ventricular strain by 2-dimensional speckle tracking for hard clinical end-points (death, heart failure hospitalization, arrhythmias) in the most frequent forms of adult congenital heart disease. In total, 19 contemporary studies were included. Current data shows that left ventricular and right ventricular global longitudinal strain (GLS) predict heart failure, transplantation, ventricular arrhythmias and mortality in patients with Ebstein's disease and tetralogy of Fallot, and that GLS of the systemic right ventricle predicts heart failure and mortality in patients post atrial switch operation or with a congenitally corrected transposition of the great arteries. Deformation imaging can potentially impact the clinical decision making in ACHD patients. Further studies are needed to establish disease-specific reference strain values and ranges of impaired strain that would indicate the need for medical or structural intervention.

Burden of HIV on Society Current Management Options and Future Prospective

Nevertheless, there is still a disparity in the availability of antiretroviral therapy (ART), especially in low- and middle-income nations, due to obstacles such as financial constraints, inadequate infrastructure,and on going social stigma. The future outlook for HIV management is optimistic, as current research is dedicated to exploring innovative treatment methods such as long-acting injectable, gene editing medicines, and therapeutic vaccinations. Furthermore, progress in pre-exposure prophylaxis (PrEP) and other preventive measures provide optimism for decreasing the number of new infections. Furthermore, it is crucial to make endeavors towards tackling societal factors that influence health outcomes, such as poverty, education, and gender inequality, as they play a vital role in attaining long-lasting advancements in HIV prevention and care. Notwithstanding these progressions, there are still obstacles to overcome, such as the rise of drug-resistant variations, deficiencies in testing and diagnosis, and enduring social obstacles. To tackle these difficulties, a comprehensive strategy is needed that combines biological, behavioral, and structural interventions, with a focus on fairness and human rights. To reduce the impact of HIV/AIDS on society and achieve the objective of ending the epidemic, it is important to continue investing in research, improving health systems, and promoting collaboration across all sectors.

Echocardiography in the Recognition and Management of Mechanical Complications of Acute Myocardial Infarction.

Although rare, the development of mechanical complications following an acute myocardial infarction is associated with a high morbidity and mortality. Here, we review the clinical features, diagnostic strategy, and treatment options for each of the mechanical complications, with a focus on the role of echocardiography. The growth of percutaneous structural interventions worldwide has given rise to new non-surgical options for management of mechanical complications. As such, select patients may benefit from a novel use of these established treatment methods. A thorough understanding of the two-dimensional, three-dimensional, color Doppler, and spectral Doppler findings for each mechanical complication is essential in recognizing major causes of hemodynamic decompensation after an acute myocardial infarction. Thereafter, echocardiography can aid in the selection and maintenance of mechanical circulatory support and potentially facilitate the use of a percutaneous intervention.

Sediment connectivity as a key to understand geomorphic effects of the Storm Alex in two mountain catchments of the Mediterranean Alps (Italy)

The occurrence of extreme rainfall events over mountain catchments is likely to trigger mass failure processes on hillslopes and sediment transport within the channel network. Understanding the degree of linkage between the sediment sources and transfer pathways downstream is essential in those catchments where settlements are affected by hydro-geomorphic processes, in order to plan suitable interventions for risk mitigation. A recent storm (October 2020) named “Alex”, estimated to be an extratropical cyclone with a more than 100-year return period, hit the Mediterranean Alps at the border between Italy and France, triggering deadly landslides and flooding processes. This work focuses on two adjacent mountain catchments located in the Liguria region (Italy) which share the same outlet, where a small village was damaged by high-magnitude sediment transport and deposition processes during the storm. In order to analyze sediment dynamics at the catchment scale leading to severe damage to the urban settlements at the outlet, an integrated approach was used. Very high resolution (0.5 m) satellite imagery was employed to map the mass failure processes on the hillslopes with a visual interpretation. This dataset was then compared with a map of the Index of Connectivity created using the SedInConnect 2.3 software to characterize the pre-event structural connectivity in both catchments. The integration of these two datasets permitted understanding that debris slides evolving into debris flows downstream supplied most of the sediments to the channel network. These processes concentrated mainly in a specific catchment where hillslopes have the highest connectivity with the valley bottom. This outcome provided a clear evidence that inventory maps developed soon after an extreme event, coupled with sediment connectivity datasets, can provide relevant information for future land management and risk mitigation strategies. These can be exploited to prioritize structural interventions in specific areas, to reduce the connectivity or disconnect inhabited areas from the hydro-geomorphic systems and avoid future damage.

An HBIM Approach for Structural Diagnosis and Intervention Design in Heritage Constructions: The Case of the Certosa di Pisa

In the conservation of monumental heritage, the collection and utilization of information are of primary importance. The Heritage Building Information Modeling (HBIM) procedure harnesses the potential of three-dimensional models, offering significant advantages in accessing documentation, interoperability, multidimensionality of intervention design, cost evaluation, and maintenance management. Our attention here is focused on the Certosa di Pisa (Italy), a large historical complex built in the 14th century as a monastery of the Carthusian Order, currently in a state of deterioration and in need of restoration and re-functionalization. The multifaceted nature of this monumental complex, with its intricate interplay of architectural elements spanning different historical periods and featuring diverse techniques, poses a significant challenge for structural safety assessment. This case study presents an opportunity to explore an HBIM approach to streamline the diagnostic process and facilitate the intervention design phase. The goal is achieved by utilizing an accurate 3D model enriched with data from multiple sources and automating certain operations for a simplified safety assessment of masonry structures under both gravity and seismic loads. The usefulness of the HBIM methodology is highlighted as a valuable tool in the realm of cultural heritage structures for both practitioners and scholars alike.

Onsite and laboratory assessment of repair mortars for reinforced concrete floor slabs in heritage buildings

The conservation and repair of XX century architectural heritage built with reinforced concrete is becoming more and more important and requires suitable materials and technical solutions. In particular, effectiveness, compatibility and durability must be ensured, in spite of the limited extent of demolition allowed by the local authorities, and the literature in this field is still limited. In this paper, an experimental campaign was carried out in an historic reinforced concrete floor slab, where different repair mortars were used. After some on-site testing on the corrosion potential, the concrete beams of the slab were integrally cut and transported to the laboratory for a series of systematic tests, aimed at investigating the performance and compatibility of the repair materials, as well as any possible issues hindering the success of this structural intervention. The filling ability, physical compatibility, chemical compatibility and mechanical compatibility of the repair mortars and the corrosion behavior of the steel reinforcement were investigated, deriving some results of general interest, which may contribute to a better insight about the repair of heritage concrete floor slabs.

Politicisation Persists and Is Increasing in European Public Service Media in the Digital Society

The open conclusions with which Hallin and Mancini (2004, 2011) approached their comparative study of Western media systems, initiated in 1998, retain their empirical, revisionist, and prospective value—even from critical perspectives—after a quarter of a century of profound historical, social, and technological changes. The names given to the three traditional media models in those authors’ first publication are used in this article to compare the evolution of funding, audience shares, governance, structure, and political intervention in European countries’ public service media on the one hand, and to contrast the operational hypothesis that politicisation persists and is increasing in European public service media in their adaptation to the digital society, on the other hand. Based on the variables from Hallin and Mancini’s empirical model, five crucial questions about the evolution of public service media in the EU are addressed: intervention and development of regulation by states and by the European Commission in the area of shared powers; a comparative analysis of the funding systems and consumer audiences of each European country’s public service media; the changes in the governance and management structures of said public service media; the variation in the professional culture and the rational-legal authority of their organisations; and the evolution and legitimation of public service media’s public value in the internet society, as well as the persistence or mutability of the national media systems’ fit within Hallin and Mancini’s three original models.

County-level political group density, partisan polarization, and individual-level mortality among adults in the United States: A lagged multilevel study

ObjectiveTo investigate the associations between county-level political group density, partisan polarization, and individual-level mortality from all causes and from coronary heart disease (CHD) in the United States. MethodsUsing data from five survey waves (1998–2006) of the General Social Survey-National Death Index dataset and the County Presidential Election Return 2000 dataset, we fit weighted Cox proportional hazards models to estimate the associations between (1) political group density and (2) partisan polarization measured at the county level in 2000 (n = 313 counties) categorized into quartiles with individual-level mortality (n = 14,983 participants) from all causes and CHD, controlling for individual- and county-level factors. Maximum follow-up was from one year after the survey up until 2014. We conducted these analyses using two separate measures based on county-level vote share differences and party affiliation ideological extremes. ResultsIn the overall sample, we found no evidence of associations between county-level political group density and individual-level mortality from all causes. There was evidence of a 13% higher risk of dying from heart disease in the highest quartile of county-level polarization (hazards ratio, HR = 1.13; 95% CI = 0.74–1.71). We observed heterogeneity of effects based on individual-level political affiliation. Among those identifying as Democrats, residing in counties with high (vs. low) levels of polarization appeared to be protective against mortality, with an associated 18% lower risk of dying from all causes (HR = 0.82, 95% CI = 0.71–0.94). This association was strongest in areas with the highest concentrations of Democrats. ConclusionsAmong all study participants, political group density and polarization at the county level in 2000 were not linked to individual-level mortality. At the same time, we found that Democratic party affiliation may be protective against the adverse effects of high polarization, particularly in counties with high concentrations of Democrats. Future research should further explore these associations to potentially identify new structural interventions to address political determinants of population health.

Socioeconomic Position, Pre-Obesity and Obesity in Latin American Cities: A Systematic Review.

Currently the socioeconomic gradient of obesity it is not well understood in the urban population in Latin American. This study reviewed the literature assessing associations between pre-obesity, obesity, and socioeconomic position (SEP) in adults living in urban areas in Latin American countries. PubMed and SciELO databases were used. Data extraction was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We extracted data on the association between SEP (e.g., education, income), pre-obesity (body mass index [BMI] ≥ 25 and < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2). Relative differences between low and high SEP groups were assessed and defined a priori as significant at p < 0.05. Thirty-one studies met our inclusion criteria and most were conducted in Brazil and Mexico (22 and 3 studies, respectively). One study presented nonsignificant associations. Forty-seven percent of associations between education or income and pre-obesity were negative. Regarding obesity, 80 percent were negative and 20 percent positive. Most negative associations were found in women while in men they varied depending on the indicator used. Pre-obesity and obesity by SEP did not follow the same pattern, revealing a reversal of the obesity social gradient by SEP, especially for women in Latin America, highlighting the need for articulated policies that target structural and agentic interventions.