Tobacco is a major preventable cause of premature morbidity and mortality. Health professionals are uniquely positioned to provide targeted interventions and should be empowered to provide cessation counselling that influence patient smoking. A cross-sectional national survey was administered to all third year students in four disciplines at the University of Malta. The Global Health Professional Student Survey (GHPSS) questionnaire was distributed to collect standardised demographic, smoking prevalence, behavioural, and attitudinal data. 81.9% completed the questionnaire (n = 173/211). A positive significant association between tobacco smoke exposure at home and current smoking status was identified. Non-smokers regarded anti-tobacco policies more favourably than smokers, being more likely to agree with banning of tobacco sales to adolescents (OR 3.6; 95% CI: 2.5–5.3; p ≤ 0.001); and with a smoking ban in all public places (OR 8.9; 95% CI: 6.1–13.1; p ≤ 0.001). Non-smokers favoured a role for health professionals in promoting smoking cessation (OR 5.1; 95% CI: 3.1–8.5; p ≤ 0.001). Knowledge of antidepressants as tools for smoking cessation was also associated with a perceived role for skilled health professionals in cessation counselling (OR 4.9; 95% CI: 1.8–13.3; p = 0.002). Smoking negatively influences beliefs and attitudes of students toward tobacco control. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models. ; This work was supported by the World Health Organization (Grant: NCE: EU ICP FFC 100 XK 08). ; peer-reviewed
Brucellosis, also known as "undulant fever" or "Malta fever", is a zoonotic infection caused by microorganisms belonging to Brucella, a genus of gram-negative coccobacilli that behave as facultative intracellular pathogens of ruminants, swine and other animals. Brucellosis is a threat to public health, hence identifying the optimal way of preventing disease spread is important. Under certain circumstances, integrated, multidisciplinary "One Health" (OH) initiatives provide added value compared to unidisciplinary or conventional health initiatives. Conceptualizing and conducting evaluations of OH approaches may help facilitate decisions on resource allocation. This article historically describes and comparesMalta's 1995–1997 with Serbia's 2004–2006 brucellosis control programmes and quantitatively assesses the extent to which they were compliant with a OH approach. For both case studies, we describe the OH initiative and the system within which it operates. Characteristic OH operations (i.e., thinking, planning, working) and supporting infrastructures (to allow sharing, learning and systemic organization) were evaluated. We scored the different aspects of these programmes, with values ranging from zero to one (1 = strong integration of OH). Malta demonstrated a higher OH index (0.54) and ratio (1.37) than Serbia (0.49 and 1.14 respectively). We conclude that context and timing are key to determining how, when and why a One Health approach should be applied. The adoption of a true OH approach that involved systemic organization, leadership clarity and transdisciplinary communication, collaboration, and co-ordination was essential to Malta's successful eradication of brucellosis after several failed attempts. In contrast, contextual factors in Serbia permitted the successful adoption of a primarily sectorial approach for short term control of brucellosis. However, while a fully-fledged transdisciplinary OH approach was not initially required, it is likely to be key to maintenance of brucellosis control in the medium and long term. Through these two case studies, we demonstrate that One Health initiatives should be applied at the right place, at the right time, with the right people and using the appropriate conditions/infrastructure. Lastly, OH evaluations should include economic assessments to identify optimal of resources in these situations, thereby justifying funding and political support required. ; peer-reviewed
Restricting children's exposures to marketing of unhealthy foods and beverages is a global obesity prevention priority. Monitoring marketing exposures supports informed policymaking. This study presents a global overview of children's television advertising exposure to healthy and unhealthy products. Twenty-two countries contributed data, captured between 2008 and 2017. Advertisements were coded for the nature of foods and beverages, using the 2015 World Health Organization (WHO) Europe Nutrient Profile Model (should be permitted/not-permitted to be advertised). Peak viewing times were defined as the top five hour timeslots for children. On average, there were four times more advertisements for foods/beverages that should not be permitted than for permitted foods/beverages. The frequency of food/beverages advertisements that should not be permitted per hour was higher during peak viewing times compared with other times (P < 0.001). During peak viewing times, food and beverage advertisements that should not be permitted were higher in countries with industry self-regulatory programmes for responsible advertising compared with countries with no policies. Globally, children are exposed to a large volume of television advertisements for unhealthy foods and beverages, despite the implementation of food industry programmes. Governments should enact regulation to protect children from television advertising of unhealthy products that undermine their health.
Mediterranean islands face significant environmental challenges due to their high population density, reliance on imports, and water scarcity, exacerbated by increasing risks from climate change. Nature-based solutions (NbS) could address these challenges sustainably and with multiple benefits, but their uptake in policy and planning is limited, and stakeholder perspectives are conspicuously lacking from current research. Here, we report the results of a collaborative, multi-stakeholder exercise to identify priority knowledge needs (KNs) that could enhance the uptake of NbS in Mediterranean islands. We used a well-established iterative prioritisation method based on a modified Delphi process. This was conducted by the authors, environmental policy and practice stakeholders from across the Mediterranean islands, representing business, government, NGOs and research. We developed a long list of potential KNs through individual submissions, and prioritised them through voting, discussion and scoring. Excepting workshop discussion, all individual contributions were anonymous. We present the 47 resulting KNs in rank order, classified by whether they can be addressed by knowledge synthesis and further research, or demand action in policy and practice. The top priority KNs are i) a more precise definition of NbS, ii) which NbS are adapted to dry Mediterranean conditions? iii) how to increase the adoption and use of NbS in urban plans?, iv) how can buildings and built-up areas be modified to accommodate green infrastructure and v) cost-benefit analysis of urban green spaces. In collaboration with these stakeholders, our findings will determine future research strategies on NbS implementation in the Mediterranean islands.
Restricting children's exposures to marketing of unhealthy foods and beverages is a global obesity prevention priority. Monitoring marketing exposures supports informed policymaking. This study presents a global overview of children's television advertising exposure to healthy and unhealthy products. Twenty-two countries contributed data, captured between 2008 and 2017. Advertisements were coded for the nature of foods and beverages, using the 2015 World Health Organization (WHO) Europe Nutrient Profile Model (should be permitted/not-permitted to be advertised). Peak viewing times were defined as the top five hour timeslots for children. On average, there were four times more advertisements for foods/beverages that should not be permitted than for permitted foods/beverages. The frequency of food/beverages advertisements that should not be permitted per hour was higher during peak viewing times compared with other times (P < 0.001). During peak viewing times, food and beverage advertisements that should not be permitted were higher in countries with industry self-regulatory programmes for responsible advertising compared with countries with no policies. Globally, children are exposed to a large volume of television advertisements for unhealthy foods and beverages, despite the implementation of food industry programmes. Governments should enact regulation to protect children from television advertising of unhealthy products that undermine their health. ; International Development Research Center, Grant/Award Numbers: 107459‐001, 107731, 107213001 and 107731‐002; Javna Agencija za Raziskovalno Dejavnost RS; Spanish Health Research Fund of the Institute of Health Carlos III, Grant/Award Number: ENPY 1015/13; Wellcome Trust; National Institute for Health Research; Medical Research Council; Economic and Social Research Council; Cancer Research UK; British Heart Foundation; Spanish Consumers Organization (OCU); Slovenian Research Agency and Ministry of Health of Republic of Slovenia, Grant/Award Number: P3‐0395; Ministry of Higher Education, Grant/Award Number: FRGS/1/2013/ SS03/UKM/02/5; Estrategia de sostenibilidad de grupos de investigación. ; Sí
Restricting children's exposures to marketing of unhealthy foods and beverages is a global obesity prevention priority. Monitoring marketing exposures supports informed policymaking. This study presents a global overview of children's television advertising exposure to healthy and unhealthy products. Twenty‐two countries contributed data, captured between 2008 and 2017. Advertisements were coded for the nature of foods and beverages, using the 2015 World Health Organization (WHO) Europe Nutrient Profile Model (should be permitted/not‐permitted to be advertised). Peak viewing times were defined as the top five hour timeslots for children. On average, there were four times more advertisements for foods/beverages that should not be permitted than for permitted foods/beverages. The frequency of food/beverages advertisements that should not be permitted per hour was higher during peak viewing times compared with other times (P < 0.001). During peak viewing times, food and beverage advertisements that should not be permitted were higher in countries with industry self‐regulatory programmes for responsible advertising compared with countries with no policies. Globally, children are exposed to a large volume of television advertisements for unhealthy foods and beverages, despite the implementation of food industry programmes. Governments should enact regulation to protect children from television advertising of unhealthy products that undermine their health.
ABSTRACT: Restricting children's exposures to marketing of unhealthy foods and beverages is a global obesity prevention priority. Monitoring marketing exposures supports informed policymaking. This study presents a global overview of children's television advertising exposure to healthy and unhealthy products. Twenty‐two countries contributed data, captured between 2008 and 2017. Advertisements were coded for the nature of foods and beverages, using the 2015 World Health Organization (WHO) Europe Nutrient Profile Model (should be permitted/not‐permitted to be advertised). Peak viewing times were defined as the top five hour timeslots for children. On average,there were four times more advertisements for foods/beverages that should not be permitted than for permitted foods/beverages. The frequency of food/beverages advertisements that should not be permitted per hour was higher during peak viewing times compared with other times (P < 0.001). During peak viewing times, food and beverage advertisements that should not be permitted were higher in countries with industry self‐regulatory programmes for responsible advertising compared with countries with no policies. Globally, children are exposed to a large volume of television advertisements for unhealthy foods and beverages, despite the implementation of food industry programmes. Governments should enact regulation to protect children from television advertising of unhealthy products that undermine their health.
Restricting children's exposures to marketing of unhealthy foods and beverages is a global obesity prevention priority. Monitoring marketing exposures supports informed policymaking. This study presents a global overview of children's television advertising exposure to healthy and unhealthy products. Twenty-two countries contributed data, captured between 2008 and 2017. Advertisements were coded for the nature of foods and beverages, using the 2015 World Health Organization (WHO) Europe Nutrient Profile Model (should be permitted/not-permitted to be advertised). Peak viewing times were defined as the top five hour timeslots for children. On average, there were four times more advertisements for foods/beverages that should not be permitted than for permitted foods/beverages. The frequency of food/beverages advertisements that should not be permitted per hour was higher during peak viewing times compared with other times (P < 0.001). During peak viewing times, food and beverage advertisements that should not be permitted were higher in countries with industry self-regulatory programmes for responsible advertising compared with countries with no policies. Globally, children are exposed to a large volume of television advertisements for unhealthy foods and beverages, despite the implementation of food industry programmes. Governments should enact regulation to protect children from television advertising of unhealthy products that undermine their health. ; In Argentina, advertising monitoring was supported by the International Development Research Center (IDRC; grant number 107459‐001). The Chilean team would like to thank the National TV Council (CNTV) that provided the TV records, as well as María Fernanda Sánchez, Camila Román, and Camila Fierro for assisting with the coding and database preparation; data coding was supported by grants from the International Development Research Center (no. 107731‐002) and Bloomberg Philanthropies. The project in Colombia was cofunded by Estrategia de sostenibilidad de grupos de investigación–University of Antioquia, Medellín, Colombia. The Colombian team wish to thank Mariana Arias Toro y Melisa Alejandra Muñoz Ruiz, School of Nutrition and Dietetics, University of Antioquia, Medellín. In Costa Rica and Guatemala, data collection and analysis was funded by IDRC grant no. 107213001. In Malaysia, this project was funded under the Fundamental Research Grant Scheme (FRGS/1/2013/SS03/UKM/02/5) of the Ministry of Higher Education. In Mexico, the financial support of this study was founded by the International Development Research Center (project number: 107731) and Bloomberg Philanthropies. The project in Slovenia was funded by the Slovenian Research Agency and Ministry of Health of Republic of Slovenia (research programme P3‐0395: Nutrition and Public Health; research project L3‐9290: sugars in human nutrition); we acknowledge the support of Dea Zavadlav (Nutrition Institute, Slovenia) in the data collection. The South African team wish to thank Prof Norman Temple, Athabasca University, Canada, and Prof Nelia Steyn, University of Cape Town, who initiated the food advertising project in South Africa. In Spain, data collection was supported by the Spanish Health Research Fund of the Institute of Health Carlos III (project ENPY 1015/13) and the Spanish Consumers Organization (OCU). The Spanish team wish to thank María José Bosqued Estefanía for her support in data management. Jean Adams and Martin White were supported by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.
