bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges in communicating evidence and policies in relation to the COVID-19 pandemic – experiences from Denmark
Authors: Krasnik A 
Published: October 2023

Abstract
Early during the COVID-19 pandemic health authorities and media in the Scandinavian countries identified an increased incidence of infections among migrants compared to the majority population. Specific neighbourhoods and communities were presented as having high incidence rates, hospitalisations and mortality. These populations were profiled by country of birth - in Denmark often categorised as non-Western immigrants which is a broad label generally presented in policy debates and by Statistics Denmark. The public discourse quickly associated this category with common Danish concepts such as parallel societies or ghetto's - the latter being a label that officially was used recently to identify communities with many immigrants and social challenges. The debate signified a frequent view that these population groups were less caring about their health, more suspicious or less motivated to comply with information from public authories and with little interest in engaging in testing and preventive activities- thereby representing a risk for the further spread of the disease and an additional burdon for health care. Only after intensive interference from migrant health experts and initiatives from the National Health Authority a more nuanced public communication gave room for description of housing and working characteristics that were common in some of the migrant communities.This slowly created more insights and acceptance of real causes of the disparities and a platform for more respectful, inclusive and efficient preventive interventions. The presentation will report on the process involved and the way the change of language had an impact on the public health policies and practice during the pandemic in Denmark.
Monitoring the nutrient content of packaged food: Design of the German product monitoring
Authors: Gréa C , Dittmann A , Kondula V , Krüger K , Roser S , Storcksdieck genannt Bonsmann S 
Published: October 2023

Abstract

Introduction
To review ongoing reformulation efforts and identify further leverage points for reducing the sugar, fat, or salt content in packaged food, an overview of the nutrient content of nationally available packaged food is essential. This can be achieved through a regular product monitoring, as it is conducted in Germany.

Methods & Data Analysis
In Germany, the product monitoring started in 2016 with a market overview of the energy and nutrient content of 19 food groups. Since 2019, it has been continued as an annual monitoring of selected frequently consumed food groups. A special emphasis within each food group lies on products targeting at children. Product information such as mandatory nutrition declaration and ingredient list is predominantly gathered manually from manufacturers’ websites and managed with FoodCASE. To facilitate data collection, a system to extract and organise the relevant food product information from websites automatically is currently being developed in a separate research project. The system combines web-scraping, artificial intelligence, generic and rule-based approaches to compile and compare data over time. Analyses of the energy and nutrient content are done on the level of food groups and subgroups. Range, mean, median, and quartiles are calculated and shown in tables and boxplots. A monitoring interval of 2-3 years allows analysing for significant changes over time by using Welch's t-test or -ANOVA. Furthermore, monitoring data is introduced into the EU Joint Action Best-ReMaP, which aims to implement a standardized monitoring system across the EU to better evaluate different national reformulation efforts.

Conclusions
Continuous product monitoring as done in Germany is an essential and effective tool to assess and guide ongoing reformulation efforts. Steps towards more harmonized monitoring across Europe will help to compare nutrient content of packaged food between different countries and identify best practices in reformulation.
Improving health and wellbeing through health-centred, evidence-based urban planning methodologies
Authors: Ruszanov A , Weller E , Jevtic M 
Published: October 2023

Abstract

Issue/problem
The relationship between urban design and human health has been repeatedly established. In fact, research has shown that urban design can influence the greatest challenges to communities’ physical, mental and social well-being around the globe. One of today's biggest health burdens is related to non-communicable diseases, and a facilitating factor in the development of these non-communicable diseases is the design of urban spaces. Currently, urban planning and revitalization are based dominantly on profit criteria with routinized methodologies, with little focus on health and wellbeing.

Description of the problem
HEART is a collaborative EU-funded project that addresses this issue by upgrading the conventional approach to urban planning towards integrated nature-based methods and concepts with emphasis on health, societal and environmental aspects through the unique concept of Health Centred Planning Methodology. The project aims to improve urban health and reduce health disparities through an innovative Blue-Green-Solutions-based implementation mechanisms of urban planning that embraces and promotes health and wellbeing as a key-planning criterion. To achieve this, HEART is engaging local communities to map the needs and challenges and to express their expectations and preferences so that delivered solutions are co-created and embraced by citizens. It also collects data from three demo sites in three cities - Athens, Belgrade, and Aarhus - to implement nature-based solutions that will address pre-identified socio-cultural, health, and well-being issues. HEART also uses medical evidence in clinical and non-clinical setting to produce evidence proving the effects of various Blue-Green Solutions on public health and wellbeing.

Lessons
Evidence generated by HEART can be used by stakeholders - such as policymakers and city and health authorities - in their decision-making process around urban planning.
On the application of AI in ethical decision-making in research ethics and ethics education
Authors: Anov A , Aleksandrova-Yankulovska S , Stateva A , Seizov A , Statev K 
Published: October 2023

Abstract

Background
ChatGPT is tested everyday by millions of users with different use cases. Exploring the gap between theoretical and practical ethical problems and how it is affected by the ongoing development of ChatGPT is one of these cases. The aim of this report is to present the results of testing ChatGPT in ethical decision-making in research ethics and its applicability in ethics education.

Methodology
The tests were conducted between February and April 2023 with 3 updates of ChatGPT in this period. GPTZero AI detector was used to test whether the AI generated text can be detected as not written by human. For ethical decision-making a 4-step model developed in Medical University - Pleven was applied to the Tuskegee experiment case.

Results
Two tests were conducted, in February and in April. In both cases ChatGPT was given a simple task to analyse the Tuskegee experiment by applying a methodology for case analysis. In February it used a 6-step method and in April it used a 4-step approach. In both cases ChatGPT managed to identify ethical problems regarding informed consent, human rights, harms. With more detailed instructions ChatGPT managed to follow them to some degree. It identified the issue of vulnerability and the relevance of Nuremberg code and Declaration of Helsinki but it couldn’t interpret them without additional plugin. Given a simple instruction ChatGPT produced a content that was detected by GPTZero as written by AI. By instructing ChatGPT for creating content with high degree of burstiness and perplexity and more detailed instructions about the methodology it produced a content of which two-thirds were detected as written by AI.

Conclusions
Given the task ChatGPT can identify ethical issues at basic level. Even with more detailed instructions it can’t go into detailed ethical reasoning. It wouldn’t be sufficient for professional ethical decision-making. It could help in ethics education but with certain limitations.

Key messages
• ChatGPT is still not able to go into detailed ethical reasoning and researchers should be careful if they plan to use it in their scientific work.
• Educators should always check whether the content of their students’ work is developed by AI and have ethical guidelines for using AI in education.
Free School Meals Extension to all 4-11 year olds in primary education in Wales
Authors: Green L , Emmerson C 
Published: October 2023

Abstract

There were 272,339 primary age students in Wales in April 2021, of whom 63,614 (23%) were entitled to free school meals. Free school meals (FSMs) are currently means tested in Wales. Estimates suggest around 40,000 children in primary education may be currently living in poverty but are not eligible for a free school meal .Free school meals have been available to all children in Reception, Year 1 and Year 2 in England since 2014. Wales does not currently have universal provision to children in any school year. However, Welsh Government committed to this for 2023/4. Steered by a Task and Finish Group, a comprehensive mixed-method HIA was conducted over a six month period in 2022-23. A comprehensive database search of peer-reviewed and grey literature published in the ten years to 2021 identified evidence relating to the impacts on health, educational attainment and household socioeconomic outcomes of making school meals free to all primary age children compared with no or means-tested provision. Routine data sources and school census data were analysed to contextualise evidence in relation to Wales. This evidence was supplemented with interviews and data provided by cross sector stakeholders. The HIA identified significant potential impacts across the determinants of health, including impacts across population groups such as children in working families on low incomes, mental well-being and food behaviours. School food policy and provision, length of lunchtimes and implementation were identified as key pathways for health impacts. For example, a strong theme was that current provision is often experienced as stressful, with requirements for rapid turnaround limiting opportunities to socialise and enjoy meals and wider opportunities to play during lunch hours constricted. The report was used to inform the Health and Education ministers who approved the extension and the implementation of the offer. The unique HIA has transferrable learning for others.

Key messages
• This work has demonstrated the value of evidence based HIA on government policy and has enhanced implementation plans.
• Free school meals for children can promote better health and educational and mental wellbeing outcomes.
Period effects in the risk of labour market marginalization among refugees in Sweden: cohort study
Authors: Kirchner S , Amin R , Niederkrotenthaler T , Cullen A E , Gémes K , Helgesson M , Mittendorfer-Rutz E 
Published: October 2023

Abstract

Background
Changes in Swedish national insurance policies over time and/or migration-related health inequalities may influence the risk for labour market marginalization (LMM) in refugees as compared to the Swedishborn host population. This study aimed to investigate potential period effects in the association between refugee status and the risk of LMM and explore any differences by country of birth, age and duration of residence.

Methods
Using national registers, three cohorts including all Swedish residents during 1999, 2004 and 2009 were followed for 4 years (cohort 2000, 2005 and 2010). Cox regression models were used to examine associations between refugee status and LMM defined as long-term unemployment (&gt;180 days annually) and disability pension. The analyses were adjusted for socio-demographic factors, morbidities and labour market-related factors. Stratified analyses were run for age, country of birth and duration of residence.

Results
Across the cohorts, hazard ratios (HRs) were higher for long-term unemployment [2000: HR = 1.98; 95% confidence interval (CI): 1.96-2.01; 2005: HR = 2.30; 95% CI: 2.27-2.33; 2010: HR = 2.78; 95% CI: 2.75-2.81] for refugees compared to Swedish-born but not for disability pension. HRs for long-term unemployment were highest among refugees aged 25-34 and 35-44 years, from Somalia, Afghanistan and Iraq and refugees with a shorter duration of residence.

Conclusions
The risk of long-term unemployment appears to have increased for refugees over time. Particularly some refugee subgroups experienced more difficulties. These findings highlight ongoing disparities for refugees and implicate on a broader scale that changes in policies such as stricter regulations in the insurance or healthcare system might adversely affect them.

Key messages
• A period effect for long-term unemployment among refugees as compared to Swedish-born could be observed, and increases in the risk estimates were particularly pronounced for specific subgroups.
• Refugees seem to face increasing challenges and difficulties over time to access the labour market and changes in policies might adversely affect this situation.
Alcohol-related morbidity and mortality by fathers’ parental leave: A quasi-experimental study
Authors: Honkaniemi H , Juárez S P 
Published: October 2023

Abstract

Background
Fathers’ parental leave has been associated with decreased risks of alcohol-related morbidity and mortality. Whether this is attributable to parental leave's health protections (via stress reduction or behavioral changes) or selection effects (via better pre-existing health) remains unclear. Based on the quasi-experimental variation of a Swedish reform that incentivized fathers’ leave use, this study aims to assess whether fathers’ parental leave influences their alcohol-related morbidity and mortality.

Methods
Using total population registers, we identified fathers of children born in Sweden from 1992 to 1997 (n = 220,412). Exposure was indicated by fathers’ reform eligibility (i.e., childbirth after January 1995) and parental leave uptake. Outcomes included rates of alcohol-related hospitalizations with acute (intoxication, mental and behavioral disorders) and chronic alcohol-related diagnoses (other diseases), as well as alcohol-related mortality, up to two, eight and eighteen years after childbirth. Interrupted time series and instrumental variable analyses were used to measure the association of fathers’ reform eligibility and leave uptake, respectively, with alcohol-related health.

Results
In interrupted time series analyses, exposure to the reform was associated with decreases in fathers’ overall and acute alcohol-related hospitalization rates up to two, eight and eighteen years after birth (e.g., two-year rates: Incidence Rate Ratio [IRR] 0.66, 95% CI 0.51-0.87), with no changes in related mortality. Instrumental variable analyses suggested that alcohol-related hospitalization decreases were driven by fathers’ leave uptake (e.g., two-year rates: IRR 0.16, 95% CI 0.03-0.84).

Conclusions
Findings suggest that fathers’ parental leave eligibility and uptake may protect against their alcohol-related morbidity in the short and long term. Parental leave incentives could be an effective public health instrument to reduce alcohol-related harms in society.

Key messages
• Parental leave could be protective for fathers’ alcohol-related health by reducing stress and discouraging risk behaviors, although selection into leave use may confound this association.
• Utilizing the quasi-experimental variation of a Swedish fathers’ parental leave policy, this study highlights the beneficial effects of leave use for fathers’ alcohol-related outcomes.
Health4EUKids project and best practices against obesity
Authors: Vantarakis A , Velissari J , Brouma M 
Published: October 2023

Abstract
“Health4EUkids” aims at the implementation to a broader level and a number of European countries in the field of health promotion and prevention of non-communicable diseases, indicating best practices and specific risk factors from research results on child obesity that have already developed from previous research actions. The “Health4EUkids” specific objectives are to:
1. Increase data and survey the requirements and prerequisite for each Member State to implement proposed best practices
2. To strengthen a cooperative approach in tackling childhood obesity by facilitating the exchange of knowledge and learning skills among Member States and the best practice providers;
3. To select and implement actions according two best practices Gruanu moves and Smart life that provide the best opportunity to tackle childhood obesity among participating Member States;
4.To improve the planning and development of the policies to tackle childhood obesity in MS at the European, national, regional and local level using either of best practices;
5. To acilitate transferability and sustainability of Best Practices to member states
‘Grunaus moves’ implementation as a best practice in tackling child obesity
Authors: Peiro Pérez R , Donat Castello L 
Published: October 2023

Abstract
Grunau moves targets children (4-12) and their environmental and living conditions and related actors, focus on deprived district (reduction of health inequalities). It aims at creating health promoting settings, environments to promote physical activity and healthy diet in children and families. This best practice confirmed differences in nutrition and opportunities for physical activity for children between advantaged and disadvantaged districts (health inequity).
Sustainability and transferability of good practices for children's health promotion, obesity and NCDs prevention and responsive parenthood
Authors: Giusti A , Cattaneo C , Scardetta P , Palermo V , Zambri F 
Published: October 2023

Abstract
A review has been conducted on the relevant results of previous European initiatives to capitalize on the outcomes of other Joint Actions addressing children's health promotion, responsive parenthood, obesity and Non-Communicable Diseases (NCDs) prevention. The aim of this review is to gather knowledge, lessons learned, tools, and recommendations. Additionally, a survey is being conducted involving the Health Authorities of EU countries to assess the current state of policies and programs. This survey provides a structured description of national systems and initiatives, while identifying barriers and facilitators. Special attention is given to the emerging needs of children associated with the Covid-19 pandemic and to the healthcare response. Based on this context analysis, recommendations will be provided and discussed with the workshop participants to guide the transferability and sustainability of good practices for children's health promotion, responsive parenthood, obesity and NCDs prevention in the involved Countries. Objective is to share and discuss with the workshop participants the preliminary recommendations to guide the transferability and sustainability of good practices for children's health promotion, obesity and NCDs prevention, and responsive parenthood.
Loneliness is associated with health behaviour: A Danish population study of 122.258 individuals
Authors: Jensen M M , Friis K , Maindal H T , Hargaard A S , Knudsen M G , Lasgaard M 
Published: October 2023

Abstract

Background
Loneliness is steadily being recognized as a public health concern due to its association with increased morbidity and mortality. Health behaviour has been proposed as a key mechanism that influences this association. The objective of the present study is to provide a comprehensive account of the relationship between loneliness and adverse health behaviour, including daily smoking, alcohol consumption, physical inactivity, unhealthy dietary habits and obesity.

Methods
We conducted a cross-sectional study using data from the 2017 Danish National Health Survey. Loneliness was assessed using a Danish version of the Three-Item Loneliness Scale. We analysed the association between loneliness and multiple forms of adverse health behaviour in 122.258 individuals aged 16 years and older using logistic regression models adjusting for sex, age, educational attainment, country of origin and cohabitation status. Stratified analyses was conducted to investigate potential differences by sex and age.

Results
Loneliness was associated with a greater risk of smoking (AOR=1.30; 95% CI: 1.21-1.40), physical inactivity (AOR=1.87; 95% CI: 1.75-1.99), unhealthy diet (AOR=1.58; 95% CI: 1.47-1.70), and obesity (AOR=1.60; 95% CI: 1.49-1.72). Conversely, loneliness was associated with a lower risk of weekly alcohol consumption (AOR=0.91; 95% CI: 0.83-0.98).

Conclusions
Our study provides evidence that loneliness is associated with an increased risk of adverse health behaviour, such as smoking, physical inactivity and unhealthy dietary intake, across the life span. These results suggest that adverse health behaviors may influence the association between loneliness and poor health. Longitudinal studies are needed to clarify causal relationships underlying these associations.

Key messages
• Loneliness is strongly associated with adverse health behaviour across the life span.
• Our study supports the theory that health behaviour is a key mechanism on the relationship between loneliness and morbidity.
Psychiatric disorders following the clustering of family disadvantages in previous generations
Authors: Li B , Almquist Y B , Liu C , Berg L 
Published: October 2023

Abstract

There is a lack of research investigating to what extent mental health is informed by the transmission of multiple disadvantages across previous generations. This study aims to investigate how family socioeconomic and psychosocial disadvantages (SP) cluster and accumulate over grandparental and parental generations, and how this might be associated with grandchild psychiatric disorders in Sweden. We studied three generations of Swedes, centered around 11,327 individuals born in 1953 (parental generation), their 22,654 parents (grandparental generation), and 24,900 children (grandchild generation). Using latent class analysis with the Bolck-Croon-Hagenaars (BCH) corrections, we first grouped SP into latent classes among the grandparental and parental generations at the family level, separately, and second, we examined the associations between the identified latent classes and grandchild psychiatric disorders. Third, latent transition analysis with BCH corrections was used to estimate the probability of transitioning from grandparental classes to parental classes, as well as the probability of grandchild psychiatric disorders for each unique transition pattern. Five distinct latent classes were identified for grandparental and parental generations, respectively. The highest probability of psychiatric disorders was found for grandchildren in grandparental class with medium-level SP, and in parental class with high-level SP, respectively. The grandparental classes with medium- and high-level SP were more likely to transition to the parental class with high-level SP. The transition pattern - constantly in high-level SP across grandparental and parental generations - has been found to predict particularly high probability of psychiatric disorders among grandchildren. Findings from this study suggest the transmission of high-level SP over grandparental and parental generations, and this is associated with particularly high likelihood of psychiatric disorders in grandchildren.

Key messages
• There is a transmission of high-level family socioeconomic and psychosocial disadvantages over grandparental and parental generations.
• The intergenerational transmission of high-level family socioeconomic and psychosocial disadvantages is associated with particularly high likelihood of psychiatric disorders in grandchildren.