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Café team leaders did not identify any significant challenges to implementation or maintenance of interventions, though low staff engagement was identified as potentially influencing the null effect on sales for healthy combination deals and healthy happy hours interventions. Customers reported low levels of awareness and high levels of support for interventions. Everyday pricing changes resulted in a significant decrease in sales of unhealthy items during the intervention period, though also resulted in a decrease in café revenue. Co-developed healthy food and beverage pricing interventions can be readily implemented with broad customer support. Everyday pricing changes have demonstrated potential effectiveness at reducing unhealthy purchases.The Roma or Gipsy population is the largest ethnic minority both in Europe and Hungary with a 10-15 years lower life expectancy and significantly worse health indicators than majority populations. The purpose of this exploratory study was to investigate a sensitive and controversial topic the perspectives of healthcare staff about the presence and impacts of implicit bias in the Hungarian healthcare system towards Roma patients. Therefore, between June 2017 and May 2018 semi-structured interviews were conducted involving 13 healthcare professionals. Interview transcripts were coded and thematically analysed. The presence and occasional manifestation of prejudices against the Romas were noted by the interviewees, most commonly in the form of longer waiting time, comments or other meta-communicative tools. Study participants appeared to exclude a direct relationship between health providers' implicit bias and the lower quality of health services or the worse health status of Roma patients. However, as reported, indirect negative effects may occur in cases where a patient refrains from seeking care due to previous perceived or experienced discrimination. As barriers to effective patient-provider communication and cooperation, differences in culture, health-seeking behaviour and gaps between health literacy levels were emphasized. In terms of prevention, enhancing anti-discriminatory attitudes from early childhood within the families, the role of media in conveying unbiased information, increasing health awareness of the Roma people as well as educating healthcare providers on culture-related issues may be beneficial. Stress and burnout of healthcare professionals also need to be addressed as these may impact on the enactment of unconscious biases.The health of Pacific people is known to be at risk because of the onset of non-communicable diseases (NCDs), such as diabetes. Inflammation inhibitor The scale of the problem requires innovative approaches to bring about change. One such approach is the development of a sustainable food system in combination with the leadership of Pacific youth. This study sought to engage Pacific youth as part of the solution to reducing NCDs through social enterprise and championing of sustainable food systems. Four young Fijian vegetable and fruit entrepreneurs shared their stories as part of a participatory action research of Talanoa/storytelling, with social media workshops, networking and promotional opportunities. Findings revealed that youth entrepreneurs are passionate about food and health, family and tradition; some are already food influencers and champions and they are keen to grow their businesses. Yet, there is limited support for small business development with a social purpose and youth-led campaigns. The study indicates a growing potential to develop local youth-led social entrepreneurship and innovation to address NCDs in exciting new ways. There is an urgent need to support innovation interventions to advocate for sustainable food systems for the Pacific, that promote positive human health needs and address, more broadly, climate change effects.

Catheter ablation is an effective treatment for post-infarction ventricular tachycardia (VT). However, some patients may experience a worsened arrhythmia phenotype after ablation. We aimed to determine the prevalence and prognostic impact of arrhythmia exacerbation (AE) after post-infarction VT ablation.

A total of 1187 consecutive patients (93% men, median age 68 years, median ejection fraction 30%) who underwent post-infarction VT ablation at six centres were included. Arrhythmia exacerbation was defined as post-ablation VT storm or incessant VT in patients without prior similar events. During follow-up (median 717 days), 426 (36%) patients experienced VT recurrence. Events qualifying as AE occurred in 67 patients (6%). Median times to VT recurrence with and without AE were 238 [interquartile range (IQR) 35-640] days and 135 (IQR 22-521) days, respectively (P = 0.25). Almost half of the patients (46%) who experienced AE experienced it within 6 months of the index procedure. Patients with AE had had long investigation.

More information on the health-related repercussions of age at onset of adolescent drinking is needed. The aim of this study was to examine the associations between self-reported age at first drink and age at first alcohol intoxication with the risk of death by age 30.

The sample (n = 6564; 49.1% males) included all participants of the Northern Finland Birth Cohort Study 1986 (NFBC1986) for whom the two measures of adolescent drinking were available. Self-reported age at onset of first drink and first alcohol intoxication were analyzed along with background variables and data regarding subsequent psychiatric diagnoses. Adolescents were dichotomized into those reporting age at first drink and age at first intoxication before or after age 14. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence interval (95% CI) for death by age 30.

By the age of 30, 0.7% (n = 47) of all 6564 participants were deceased. In the multivariable models, male gender and a history of illicit substance use in adolescence were associated with both all-cause mortality and mortality due to accidents or suicide. After controlling for confounding variables, age at first alcohol intoxication was associated with all-cause mortality (HR 2.33; 95% CI 1.04-5.20) as well as death due to accidents or suicide (HR 2.99; 95% CI 1.11-8.05).

Earlier age at first intoxication carries long-term repercussions with respect to premature loss of life. Efforts should be made targeting the prolongation of initiating binge drinking in adolescence to diminish this mortality risk.

Earlier age at first intoxication carries long-term repercussions with respect to premature loss of life. Efforts should be made targeting the prolongation of initiating binge drinking in adolescence to diminish this mortality risk.