Cross-sectional associations of schoolchildren's fruit and vegetable consumption, and meal choices, with their mental well-being: a cross-sectional study.

Background: Poor mental well-being is a major issue for young people and is likely to have long-term negative consequences. The contribution of nutrition is underexplored. We, therefore, investigated the association between dietary choices and mental well-being among schoolchildren.

How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England.

Objectives: Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed to compare patient-reported access to English primary care for adults with and without physical disability.

Change in tobacco excise policy in Bulgaria: the role of tobacco industry lobbying and smuggling.

Objectives: To examine how transnational tobacco companies (TTCs) tried to penetrate the Bulgarian cigarette market and influence tobacco excise tax policy after the fall of communism and during Bulgaria's accession to the European Union (EU).

Design: Analysis of internal tobacco industry documents supplemented by analysis of press coverage, tobacco industry journals, market reports and key informant interviews.

Results: TTCs have been involved in cigarette smuggling to and through Bulgaria since at least 1975 and used smuggling as a market-entry strategy.

Regulatory barriers to equity in a health system in transition: a qualitative study in Bulgaria.

Background: Health reforms in Bulgaria have introduced major changes to the financing, delivery and regulation of health care. As in many other countries of Central and Eastern Europe, these included introducing general practice, establishing a health insurance system, reorganizing hospital services, and setting up new payment mechanisms for providers, including patient co-payments. Our study explored perceptions of regulatory barriers to equity in Bulgarian child health services.

Economic crisis and communicable disease control in Europe: a scoping study among national experts.

Objectives: The effects of the current global economic crisis on the spread and control of communicable diseases remain uncertain. This study aimed to explore experts' views about the impact of the current crisis and measures that have been undertaken by governments to mitigate an alleged adverse effect of the crisis on communicable diseases.

Methods: An online survey was conducted during November 2009-February 2010 among experts from national agencies for communicable disease control from European Union (EU) and European Free Trade Association (EFTA) countries.

The Soviet legacy in diagnosis and treatment: Implications for population health.

This article reviews diagnosis and treatment in the Commonwealth of Independent States in three clinical areas: tuberculosis, substance misuse, and neurological disorders in children. While the specific problems in each of these areas differ greatly, commonalities emerge, pointing to the continued influence of the Soviet past. Although progress in developing evidence-based medicine is being made, the isolation of Soviet science from Western developments has resulted in the widespread use of outdated diagnostic procedures and treatment protocols, while finance mechanisms still encourage unnecessary hospitalizations and treatments.

The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence.

There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis.

Policy challenges to the quality of child health services in Bulgaria.

Background: Our study aimed to explore policy challenges to the quality of child health services in Bulgaria.

Methods: The study was based on qualitative in-depth interviews, analysis of regulatory documents, and review of the literature. Respondents included policy-makers, providers and users of health services, from both rural and urban areas.

Perceived barriers to the development of modern public health in Bulgaria: a qualitative study.

Objectives: This qualitative investigation documents Bulgarian perspectives on public health following its accession to the European Union (EU) and explores perceived obstacles to the modernization of public health sciences to more effectively address the country's high rates of premature avoidable mortality.

Methods: 28 semi-structured interviews were conducted throughout Bulgaria in April 2007 with Bulgarian academics, clinicians, policymakers and students in Sofia, Varna and Pleven. Full transcripts were subjected to formal thematic analysis.

Patients' self-assessed functional status in heart failure by New York Heart Association class: a prognostic predictor of hospitalizations, quality of life and death.

Background: Clinician-assigned New York Heart Association (NYHA) class is an established predictor of outcomes in heart failure. This study aims to test whether patients' self-assessment of functional status by NYHA class predicts hospital admissions, quality of life, and mortality.

Methods And Results: This was an observational study within a randomized controlled trial.

Access to health care for Roma children in Central and Eastern Europe: findings from a qualitative study in Bulgaria.

Background: Despite the attention the situation of the Roma in Central and Eastern Europe has received in the context of European Union enlargement, research on their access to health services is very limited, in particular with regard to child health services.

Methods: 50 qualitative in-depth interviews with users, providers and policy-makers concerned with child health services in Bulgaria, conducted in two villages, one town of 70,000 inhabitants, and the capital Sofia.

Results: Our findings provide important empirical evidence on the range of barriers Roma children face when accessing health services.

Impact of health reforms on child health services in Europe: the case of Bulgaria.

Background: In the last two decades, all countries in Europe have embarked on substantial health reforms, introducing new models of financing and provision of health services. Using Bulgaria as a case study, this article examines the impact of the reforms on child health services.

Methods: This is the first of a series of papers drawing on a broader research on inequalities in access to child health services, using Bulgaria as a case study.