INTRODUCTION: The projected growth of Alzheimer's disease (AD) and AD-related dementia (ADRD) cases by midcentury has expanded the research field and impelled new lines of inquiry into structural and social determinants of health (S/SDOH) as fundamental drivers of disparities in AD/ADRD. METHODS: In this review, we employ Bronfenbrenner's ecological systems theory as a framework to posit how S/SDOH impact AD/ADRD risk and outcomes. RESULTS: Bronfenbrenner defined the "macrosystem" as the realm of power (structural) systems that drive S/SDOH and that are the root cause of health disparities. These root causes have been discussed little to date in relation to AD/ADRD, and thus, macrosystem influences, such as racism, classism, sexism, and homophobia, are the emphasis in this paper. DISCUSSION: Under Bronfenbrenner's macrosystem framework, we highlight key quantitative and qualitative studies linking S/SDOH with AD/ADRD, identify scientific gaps in the literature, and propose guidance for future research. HIGHLIGHTS: Ecological systems theory links structural/social determinants to AD/ADRD. Structural/social determinants accrue and interact over the life course to impact AD/ADRD. Macrosystem is made up of societal norms, beliefs, values, and practices (e.g., laws). Most macro-level determinants have been understudied in the AD/ADRD literature.

• MeSH
• Alzheimerova nemoc * MeSH
• demence * MeSH
• lidé MeSH
• sociální determinanty zdraví MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH

• MeSH
• psychoterapie metody   MeSH
• rodinná terapie metody   MeSH
• skupinová psychoterapie MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Psychiatrie
• NLK Obory
• psychiatrie
• psychoterapie

OBJECTIVES: It has been known that social environments are associated with adolescents' health. However, the complex relationship between diverse types of social environments and adolescents' psychosomatic heath remained unclear. Thus, using an ecological perspective, the current study aimed to examine the associations between social environment and adolescents' psychosomatic health. METHODS: We used the data from the Health Behavior in School-aged Children (HBSC) project conducted in the Czech Republic in 2018. A total of 13377 observations were included. RESULTS: The region, as a macrosystem, could not explain the variance in adolescents' psychological and somatic health. The quality of neighborhood environment (exosystem) was significantly related to adolescents' psychological and somatic health. At the microsystem level, teacher support had stronger, family support had weaker, and peer support had no association with psychological and somatic health. At the mesosystem level, the interactions between family, teacher, and friend support were negligible for adolescents' psychological and somatic health. CONCLUSIONS: The results underscore the importance of teachers' support and neighborhood environment for adolescents' psychosomatic health. Therefore, the findings suggest the need to improve teacher-adolescent relationships and the neighborhood community quality.

• Publikační typ
• časopisecké články MeSH

BACKGROUND: Harm reduction services, despite their proved effectiveness in the prevention of infectious diseases, are still underdeveloped in several European states. The situation in the Visegrad Group countries is especially interesting. Notwithstanding the shared history, culture and political situation in the last decades, there are significant differences in the state of harm reduction between the countries. METHODS: The research applies the ecological systems model to identify the structural barriers and facilitators affecting organisations providing needle exchange services. It uses a comparative multiple case study design with embedded units of analysis complemented by within-case analysis to establish the relationship between the number and scope of identified factors and the performance of needle exchange services. The qualitative data were collected through semi-structured interviews with professionals working in needle exchange services in the Czech Republic, Poland, Slovakia and Hungary. Additionally, relevant documents, reports and online sources were analysed. RESULTS: A total of 24 themes (structural factors) were identified across 11 categories on 3 levels (mesosystem, exosystem, macrosystem). The list includes themes related to the broader society, politics and policy on state and local level, frameworks and amounts of funding, the situation on the education labour market, and attitudes of local communities, among others. The data shows that in the Czech Republic, many facilitators can be identified. In the three remaining countries, on the contrary, one can observe mostly barriers in NSP services delivery. CONCLUSIONS: The study addresses a highly unexplored topic of the functioning of harm reduction organisations in East-Central Europe. It sheds light on the environment of analysed services, identifying a number of structural factors in effective service delivery in the Czech Republic, Poland, Slovakia and Hungary. The research confirms the significant role of the barriers and facilitators in the services' performance. It highlights the relationships between various elements of the needle exchange programmes' environment, suggesting holistic strategies for addressing them. It also provides a potential starting point for further research.

• MeSH
• intravenózní abúzus drog rehabilitace   MeSH
• kulturní charakteristiky MeSH
• lidé MeSH
• poskytování zdravotní péče organizace a řízení   MeSH
• programy výměny jehel a stříkaček organizace a řízení   zásobování a distribuce   MeSH
• snížení rizika poškození MeSH
• zdravotní politika MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Maďarsko MeSH
• Polsko MeSH
• Slovenská republika MeSH