bluuebunny/crossref_metadata_2025_split huggingface dataset:
Foresight for policy making to be better prepared for the future
Authors: Moye-Holz D , Mutubuki E N , de Vries M , Hilderink H 
Published: October 2023

Abstract

Background
The COVID-19 pandemic showed that we were not prepared for unexpected and uncertain events. Foresight provides a process that explores the future to anticipate such events and be better prepared. However, in public health, foresight is underdeveloped and underused. It is necessary that policy makers and stakeholders realize the potential and benefits of including foresight into the policy cycle and advocate towards its implementation.

Methods
Foresight provides a systematic, participatory, and vision-building process that explores the future to anticipate trends and support present-day actions. It provides a participatory platform to discuss such trends and explore different scenarios to get insights into possible challenges and how to address them.

Results
Foresight studies can allow policy makers to discuss trends, build scenarios, and anticipate future challenges while also exploring desirable futures. We propose several recommendations to professionals and policy makers to include foresight into the policy cycle to promote sustainable and resilient health systems.

Conclusions
Foresight does not predict the future, it rather explores it through plausible scenarios that consider uncertainty. It provides an overview into possible future challenges to allow present-day policies that anticipate and address these challenges. Implementing foresight into the policy cycle can be a strategic tool towards addressing uncertain challenges and building desirable futures.
Socioeconomic inequalities in noncommunicable diseases in Portugal: an analysis of three decades
Authors: Martins Teixeira M , Varela A , Santos J V , Perelman J , Leão T 
Published: October 2023

Abstract

Background
Least favored people experience poorer health than those with higher socioeconomic (SE) status. These inequalities are mainly due to disparities in noncommunicable diseases (NCD). Over the last decades, Portugal experienced important SE challenges, including the recession, making it fundamental to assess how health inequalities have been affected. Hence, this study aimed to examine the evolution of SE inequalities in the prevalence of NCD in Portugal in the last 32 years.

Methods
We used data from all the six National Health Interview Surveys (1987, 1995, 1999, 2005, 2014, and 2019). Considering the main causes of morbimortality and data availability, we selected seven self-reported NCD: diabetes, hypertension, stroke, acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), asthma, and depression. We estimated the relative (RII) and absolute (SII) indexes of inequalities using education and income as proxies for SE status, adjusted for sex and age, for each NCD and survey.

Results
Regarding education, RII decreased until 2005 but increased since 2005 for diabetes (RII87=4.4; RII05=2.0; RII19=2.6) and hypertension (RII87=1.8; RII05=1.3; RII19=1.8). For asthma, RII oscillated until 2005 but increased since then (RII05=0.9; RII19=1.9). Although data for the remaining diseases are only available since 2005, an upward trend in educational RII is noticeable in stroke (RII05= 2.1; RII19=4.3), AMI (RII05=0.9; RII19=3.4), COPD (RII05=1.4; RII19=2.2), and depression (RII05=0.9; RII19=2.1). The results for SII and using income as SE indicator followed similar trends.

Conclusions
This study found persisting inequalities in NCD, with an increasing trend after 2005. These findings are of concern since they emphasize the persistence of health inequalities and the vulnerability of the most deprived groups to economic crisis. Health and social policies are crucial to attenuate these inequalities, especially considering the announced financial crisis.

Key messages
• In Portugal, socioeconomic inequalities in noncommunicable diseases have been increasing since 2005.
• It is crucial to tackle inequalities in health, especially considering the predicted economic crisis and the vulnerability of the most deprived groups to such events.
Contribution of meat-free days, meat-free meals, and portion sizes to UK meat consumption declines
Authors: Bellows A , Jaacks L , Alexander P , Stewart C 
Published: October 2023

Abstract

Background
In the UK, reduced meat consumption is needed to protect planetary health and reduce noncommunicable disease. An analysis of the UK's National Diet and Nutrition Survey (NDNS) found from 2008-2019, daily meat consumption per capita decreased from 103.7g to 86.3g (∼1.7% per annum). This trend is not fast enough to meet reduction targets, such as the National Food Strategy's goal of a 30% reduction by 2030.

Objectives
This study aimed to examine behaviours driving the reduction in meat consumption. Specifically, we investigated two key strategies: reduced consumption frequency and smaller portion sizes.
Design: Using NDNS rolling programme (2008/09-2018/19) data, we evaluated changes in: 1) the number of meat-eating days, 2) the number of meat-containing meal occasions, and 3) the portion size of meat per meat-containing meal occasion using Poisson and linear regression models. Meat consumption was based on disaggregated data from 4-day food diaries. Using decomposition analysis, we estimated the proportion of responsibility for each consumption behaviour relative to the overall decrease in consumption.

Results
The mean number of meat-eating days decreased from 3.3 to 3.0 days (P &lt; 0.001), the mean number of daily meat-containing meal occasions decreased from 1.2 to 1.1 occasions (P = 0.01), and the mean portion size of meat decreased from 85.8g to 76.1g (P &lt; 0.001). Portion size contributed most to the reductions in meat consumption (57%), followed by meat-eating days (37%), and meat-containing meal occasions (6%).

Conclusions
Our findings suggest the decrease in UK meat consumption can be largely attributed to smaller portion sizes of meat. Understanding the nuances of meat consumption behaviours (i.e., “meat-free days” vs. “meat-free meals” vs. “low-meat meals”) could help tailor behaviour change interventions by showing the need for a focus on promoting low-meat meals to accelerate reductions in meat consumption toward population and environmental health goals.

Key messages
• The decrease in UK meat consumption is largely being driven by reductions in portion size of meat at meal occasions.
• Understanding nuances of meat consumption behaviours can help tailor behaviour change interventions by showing the need for a focus on promoting low-meat meals to accelerate reduced meat consumption.
Healthcare providers’ insights on enhancing health literacy and access for Arab Bedouin in Israel
Authors: Shibli H , Limor Aharonson-Daniel L , Feder-Bubis P 
Published: October 2023

Abstract

Background
The Arab Bedouin minority is considered as one of the most vulnerable populations in Israel due to socio-cultural factors that affect their healthcare utilization patterns. This study investigates continuity of care and health literacy within the Bedouin community, aiming to identify gaps and barriers to healthcare services (HS) utilization for Bedouins, as perceived by healthcare providers serving this community.

Methods
A qualitative study was conducted June 2019 and January 2022, involving in-depth semi-structured interviews with 32 healthcare providers from community health centers/clinics in Bedouin villages and towns in Southern Israel, as well as Soroka Medical Center. Thematic analysis was used to analyze the collected data, and trustworthiness was ensured through audit, reflexivity, and peer debriefing.

Results
Healthcare providers identified factors that hinder HS utilization and the absence of various healthcare options for Bedouin patients. Interviews revealed discontinuity in treatment due to insufficient health literacy and unaffordability of medications. Additionally, many Bedouins choose to forgo or delay their visits to the community health services and visit the Emergency Department directly, because of physical, cultural, and gender barriers. Elderly Bedouins are a particularly vulnerable subgroup, susceptible to complications from chronic diseases such as diabetes and hypertension.

Conclusions
This study highlights the necessity of targeted interventions to improve healthcare access for Bedouin minority population, particularly tailoring HS to elderly subgroups. Potential interventions comprise health education programs designed to enhance health literacy, address medication affordability, and confront cultural and gender barriers obstructing access to primary care services. These findings hold implications for public health policies and initiatives addressing healthcare disparities among minority groups worldwide.

Key messages
• Health literacy is a key barrier for the Bedouin minority in Israel, with global implications for addressing healthcare disparities in minority groups.
• Targeted interventions, like health education programs, are needed to improve healthcare access for Bedouin minority, especially the elderly subgroup.
A solution-focused coaching approach to promote adolescent mental well-being in a school setting
Authors: Gustafsson J , Öster S 
Published: October 2023

Abstract
Solution-focused brief coaching departs from the idea that a focus on the clients’ strengths and hopes for the future, rather than on past or present problems, will lead them to do more of what works well and move them toward a desired future. Compared to a problem-oriented approach, the solution-focused is systemic and interactive; the client is viewed as a resourceful individual in a context and as an expert on his or her own life. From this foundation, the Solution-focused Intervention for mental health (SIM) was developed for students in upper secondary school. SIM builds upon four fundamental assumptions. First, an understanding of the cause of a personal problem does not necessarily bring the student closer to a solution of it, or to a desired future. Second, what we focus our attention on and the language we use to describe and discuss our health will grow on us. Third, all students “want to and can do something” that can lead them towards their desired future. Fourth, all students are resourceful and can act in a self-desired direction. During the coaching process in SIM, what the students “hope will start to happen and resources and abilities that can make this possible” are explored and reinforced with a solution-focused dialogue. With support from a group coach and their classmates, students are encouraged to explore what could help towards a desired future and what efforts need to be taken to move in this direction. This is followed up in future sessions by focusing on what works well and efforts made towards what is wanted. The solutions-focused coaching approach, and its associated techniques, aim to engage the students in a process that enhances the awareness and motivation to explore their own strengths and resources so as to engender self-efficacy and self-confidence and strengthen their desire to further develop their abilities and skills. The objective of the process is to establish a mental health promotion that is positively self-reinforcing.
5.A. Workshop: Reducing and monitoring sugar, fat, and salt in packaged food: Germany and the European context
Authors:   Organised by: Max Rubner-Institute (Germany),   Chair persons: Corinna Gréa (Germany), Anna Dittmann (Germany)
Published: October 2023

Abstract

Today, packaged food constitutes more than 50 % of the food supply in most European households. Many of those products are high in energy, sugar, fat, and salt, and consuming them is positively associated with overweight and obesity. Measures such as taxation and reformulation of packaged food high in sugar, fat, or salt are considered effective means to improve food environments and facilitate healthier food choices for individuals. However, the measures as well as their implementation and evaluation vary across Europe. The aim of this workshop is to give an overview of the different actions taken to stimulate the reformulation of food and beverages. Furthermore, we will present the German monitoring of packaged food, including selected findings, as one example to guide such reformulation initiatives. In the first part of our workshop we summarize existing measures in Europe to facilitate health-promoting food choices, focusing on reformulation measures and related monitoring approaches: Presentation 1 will give a systematic overview of measures to reduce sugar, fat, and salt content of food and beverages in selected European countries (Abstract 1). With presentation 2, we will give methodological insights into the German monitoring of the energy and nutrient content in packaged food (Abstract 2). Presentation 3 will focus on the latest results of the German product monitoring, with an emphasis on sugar reduction in soft drinks, yoghurts, and breakfast cereals. Furthermore, we will compare our results to those of other European countries and highlight methodical differences (Abstract 3). In the second half of the workshop, we aim to discuss our findings with the participants. Participants are encouraged to contribute further examples and experiences from their countries, which then will be discussed and documented. Opening questions and polls will be used to stimulate active involvement. Our workshop aims to contribute to better reporting of existing measures and reformulation monitoring methods in Europe, as information is often limited and only available in respective national languages. Moreover, we hope to create a community of practice to continue exchange on the effectiveness of the respective measures and good practice models across Europe.

Key messages
• The workshop gives an overview of different measures to reduce sugar, fat, and salt content in packaged food in Europe, incl. related monitoring.
• The workshop provides a platform to exchange experiences in packaged food monitoring and stimulate scientific exchange and transparency within this area.
Measures to reduce sugar, fat, and salt content of food and beverages in selected European countries
Authors: Dittmann A , Luft T , Mendoza Pardo C , Storcksdieck genannt Bonsmann S 
Published: October 2023

Abstract

Introduction
Improving food environments to promote healthy diets is a core element of many nutrition and health policies. Government-driven attempts at achieving such improvements comprise mandatory and voluntary measures to reduce the content of sugar, fat, and salt in food and beverages. Here we provide an overview of the different measures taken in selected European countries.

Methods
A systematic internet search for ongoing or planned national reduction measures in each of the three categories of taxation, legal limits/bans, and self-commitments was conducted for 19 European countries. Core characteristics of each measure, including evaluations thereof, were extracted and summarized.

Results
The measures varied in, e.g., the nutrients, product groups, and sectors addressed (manufacturing, retail, out-of-home), the timeframe, and the target values. Taxation (15 countries) mainly concerned sweetened beverages, with tax levels mostly depending on the sugar content. Independent evaluations concluded that the tax introduction had led to the sugar content being reduced as well as consumer demand shifted towards lower-sugar options. Six countries had legal limits for the salt content in bread (limits between 1.3 g and 2 g/100 g bread), and nine countries set legal limits for sugar, fat, and salt in food or meals or vending bans for products high in these nutrients in food service for the public sector. The limited evaluations of compliance with the upper limits were ambivalent. Voluntary commitments (12 countries) mainly concerned the reduction of salt and sugar. Independent studies and monitoring results on the achievement of the agreements showed mixed results.

Conclusions
National measures to reduce sugar, fat, and salt in food and drinks varied in content and depth, and thus in their likely ability to contribute to a healthier food environment. More comprehensive monitoring and evaluation is needed to better assess the effectiveness of the different approaches.
Reexploring problematic social media use and the relationship with adolescent mental health
Authors: Reiten Finserås T , Johnsen Hjetland G , Sivertsen B , Colman I , Træland Hella R , Olesen Andersen A I , Skogen J C 
Published: October 2023

Abstract

Background
Previous approaches used to assess problematic social media use risk inflating prevalence numbers and classify unproblematic social media use as addictive or problematic. The main aim of this study was to take an exploratory view as to how different types of activities, experiences, and motivations on social media are associated with problematic mental health outcomes in adolescents.

Methods
This study is based on a cross-sectional survey of 2023 adolescents (mean age 17.4 years (SD 0.9), 44.4 % males) from 2020. Exploratory graph analysis, Mokken scaling analysis and confirmatory factor analysis were performed on 28 pre-selected items assessing adolescents’ activities, experiences, and motivations on social media, to identify underlying potentially problematic factors associated with social media use. Sets of gender-adjusted multiple linear regression analyses were performed to assess the degree to which social media factors predicted depression, anxiety, well-being, and time spent on social media.

Results
Three factors were identified and named: 1) ‘subjective overuse’, 2) ‘social obligations’, and 3) ‘source of concern’. All three factors showed significant positive associations with mental health problems. The factor ‘source of concern’, which identifies feelings of being overwhelmed and concerned over social media use, had the strongest association to mental health problems and simultaneously the weakest association to time spent on social media.

Conclusions
Three identified factors measuring problematic social media use showed positive associations with mental health problems. This lends support to the notion that problematic social media use is a multidimensional phenomenon.

Key messages
• Being overwhelmed and concerned over social media use had the strongest association to mental health problems and simultaneously the weakest association to time spent on social media.
• The results from this study lends support to the notion that problematic social media use is a multidimensional phenomenon.
Build health in childhood: is it possible to promote health through a social media campaign?
Authors: Cattaneo C , Pani P , Palermo V , Maurel E , Nardone P , Scardetta P , Dittami A , Menzano M T , Carletti C V ,   Project Research Group BIG
Published: October 2023

Abstract

Introduction
Given the rise of overweight rate among Italian school-aged children (detected by the surveillance system “OKkio alla SALUTE”-WHO-COSI Italy, a communication campaign, addressed to parents, was carried out on social media to promote knowledge and encourage healthy choices to improve children's well-being. Social media allows both to inform users and to actively involve them through an exchange of ideas and opinions. The National Institute of Health, the IRCCS Burlo Garofolo and the Ministry of Health promoted this initiative.

Methods
The campaign consisted in the dissemination, through the institutional page “Guadagnare Salute” on FB and IG, of messages, videos and infographics about a healthy lifestyles. An evaluation plan was set up. Data considered 16/11/2022-04/12/2023 on FB.

Results
The campaign started on November 23rd 2022 and will end in May 2023. 33% of the published posts were sponsored. Users. In the considered timeframe, FB users increased by 78%; 86% were women aged between 35 and 54. The most significant user increase occurred during: a. the first three weeks of the social media campaign and b. after the Christmas break. Exposure. 483.926 users viewed the published contents and 15.056 visited the FB page. Involvement. What affected most the post coverage was: a. sponsorships; b. type and topic of content. The topic that most interested the users was physical activity (active mobility and physical activity in school). Some particular posts about fruit and vegetable consumption, healthy eating and sedentary lifestyle also had a high engagement rate. The topic of sugar-sweetened beverages received the most controversial comments.

Conclusions
Currently, there still is little evidence on the role that social media has on actually changing attitudes and health behaviors among people. The initiative aims to provide further evidence of institutional channels using social media for health promotion purposes.

Key messages
• Social media could be a key communication channel, especially in order to reduce inequalities.
• Evidence about the effectiveness of social media as a health promotion setting is still limited.
Waves of inequality: Income differences in intensive care due to Covid-19 in Sweden
Authors: Cederstrom A , Gauffin K , Östergren O 
Published: October 2023

Abstract

Background
Individuals in lower social strata were overall more likely to develop severe Covid-19 during the pandemic. However, specific conditions in terms of preparedness, knowledge and the properties of the virus itself changed during the course of the pandemic. Socioeconomic inequalities in Covid-19 may therefore shift over time. This study examines the relationship between income and intensive care (ICU) episodes due to Covid-19 in Sweden during three distinct waves.

Methods
This study uses Swedish register data on the total adult population and estimate the relative risk (RR) of ICU episodes due to Covid-19 by income quartile for each month between March 2020 and May 2022, and for each wave, using Poisson regression analyses.

Results
The first wave had modest income-related inequalities, while the second wave had a clear income gradient, with the lowest income quartile having an increased risk compared to the high-income group (RR: 1·55 [1·36 - 1·77]). In the third wave, the overall need for ICU decreased, but relative risks increased, particularly the top and bottom income quartiles (RR: 3·72 [3·50 - 3·96]). Inequalities in the third wave were partly explained by differential vaccination coverage by income quartile, although substantial inequalities remained after adjustment for vaccination status (RR: 2·39 [2·20 - 2·59]).

Conclusions
The study highlights the importance of considering the changing mechanisms that connect income and health during a novel pandemic. Health inequalities per income group increased for each subsequent wave. As the aetiology of Covid-19 became better understood those with more resources could better protect themselves from infection. Understanding the social dynamic of infectious diseases can help prepare for possible future pandemics.

Key messages
• Health inequalities in severe covid-19 infections increased as the pandemic progressed.
• Understanding the social dynamic of infectious diseases can help prepare for possible future pandemics.