Open access for scholarly books : policy and practice

Fierce debates have characterised 2013 as the implications of government mandates for open access have been debated and pathways for implementation worked out. There is no doubt that journals will move to a mix of gold and green and there will be an unsettled relationship between the two. But what of books? Is it conceivable that in those subjects, such as in the humanities and social sciences, where something longer than the journal article is still the preferred form of scholarly communications that these will stay closed? Will it be acceptable to have some publicly funded research made available only in closed book form (regardless of whether print or digital) while other subjects where articles are favoured go open access? Frances Pinter is in the middle of these debates, having founded Knowledge Unlatched (see www.knowledgeunlatched.org). KU is a global library consortium enabling open access books. Knowledge Unlatched is helping libraries to work together for a sustainable open future for specialist academic books. Its vision is a healthy market that includes free access for end users. In this session she will review all the different models that are being experimented with around the world. These include author-side payments, institutional subsidies, research funding body approaches etc. She will compare and contrast these models with those that are already in place for journal articles. She will also review the policy landscape and report on how open access scholarly books are faring to date Frances Pinter, Founder, Knowledge Unlatched, UK

Engaging children and young people in creating resilient and healthy urban spaces

Urban public space in Australia and internationally, can be critically examined from a number of multidisciplinary standpoints, including human geography, urban design, planning, sociology, and public health. Viewing urban public space from a range of perspectives encourages different vantage points to emerge and questions around health, wellbeing and public space are increasingly topical and important in the broadest of terms, with public space being a key arena for physical activity, mental health, commercial, cultural and community life and the possibility of social inclusion. However, in the name of urban regeneration, programs of securitisation, ‘gentrification’ ‘creative’ and ‘smart’ city initiatives refashion public space as sites of selective inclusion and exclusion (Watson 2005; Gabrys 2014). In this context of monitoring and control procedures, in particular, children and young people’s use of space in parks, neighbourhoods, shopping malls and streets, is often viewed as a threat to social order, requiring various forms of remedial action, such as being ‘designed out’ of public space (Johnson 2014). Rarely are children and young people actively and respectfully brought into planning and governance processes and consequently many urban public spaces are essentially adult places, where control and ongoing surveillance are the key concerns (Freeman 2011, Dee 2013). There is also a political economy of public space discernable in cities like Brisbane, where ‘flagship’ infrastructure such as road tunnels take pride of place, while more humbly appointed pedestrian footpaths are often narrow, in a poor state of repair and a potential barrier to good health (Atkinson and Easthope 2009). The recent development of bikeways in Brisbane is a case in point, presenting both challenges and opportunities in being a valuable new form of public space heavily used by ‘commuter cyclists’ by day, but poorly lit and conceived, for a range of users at other times (Wyeth 2014). This paper concentrates on questions of social citizenship rights and discourses of health and wellbeing and suggests that cities, places and spaces and those who seek to use them, can be resilient in maintaining and extending democratic freedoms, calling surveillance, planning and governance systems to account (Smith 2014). The active inclusion of children and young people better informs the implementation of public policy around the design, build and governance of public space and also understandings of urban citizenship, leading to healthier, more inclusive, public space for all (Jacobs 1965).

Using digitally distributed vulgar comedy to reach young men with information about healthy sexual development

Focus groups show that young men do not have available to them the same resources to learn about healthy sexual development as do young women. A collaborative project led by a leading provider of sexuality education aimed to reach young men with information about healthy sexual development by using a genre that focus groups showed they favoured - vulgar comedy. This project raised two important issues. First, comedy is ambivalent - it is by definition not serious or worthy. This challenges health communication, which traditionally favours the clear presentation of correct information. Second, vulgarity can be challenging to the institutions of health communication, which can be concerned that it is inappropriate or offensive. This article addresses these issues and reports on the materials that emerged from the project.

Social policy implications relating to road trauma in a rapidly motorising world : the example of China

The World Health Organization (WHO) identifies road trauma as a major public health issue in all countries, though most notably among low-to-middle income countries and particularly those experiencing rapid motorisation, such as China. As China transitions from a nation of bicycle riders and pedestrians to one where car ownership is increasingly desired, there is need to address the accompanying social policy challenges. With this increased motorisation has come an increased road trauma burden, shouldered disproportionately among the population. Vulnerable road users (i.e., pedestrians, cyclists, motorcyclists) are of primary concern because they are most frequently killed in road crashes, representing approximately 70% of all Chinese road-related fatalities. The aim of this paper is to summarise the scale of the road trauma burden, highlight the disparity of this burden across the Chinese population, and discuss the related social policy implications in dealing with the impact of deaths and of otherwise healthy lives diminished by injury and disability. Future research priorities are also discussed and include the need to strive to provide detailed information on the level of inequity of the road trauma burden across the population and identify appropriate social supports and healthcare services required, both preventative and post-crash, so these can be developed and implemented throughout China.

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: Quantifying the epidemiological transition

Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age–sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. Methods We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Findings Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6–6·6), from 65·3 years (65·0–65·6) in 1990 to 71·5 years (71·0–71·9) in 2013, HALE at birth rose by 5·4 years (4·9–5·8), from 56·9 years (54·5–59·1) to 62·3 years (59·7–64·8), total DALYs fell by 3·6% (0·3–7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6–29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non–communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. Interpretation Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition—in which increasing sociodemographic status brings structured change in disease burden—is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions.

Measuring cost and affordability of healthy and less healthy diet globally

The INFORMAS food prices module proposes a step-wise framework to measure the cost and affordability of population diets. The price differential and the tax component of healthy and less healthy foods, food groups, meals and diets will be benchmarked and monitored over time. Results can be used to model or assess the impact of fiscal policies, such as ‘fat taxes’ or subsidies. Key methodological challenges include: defining healthy and less healthy foods, meals, diets and commonly consumed items; including costs of alcohol, takeaways, convenience foods and time; selecting the price metric; sampling frameworks; and standardizing collection and analysis protocols. The minimal approach uses three complementary methods to measure the price differential between pairs of healthy and less healthy foods. Specific challenges include choosing policy relevant pairs and defining an anchor for the lists. The expanded approach measures the cost of a healthy diet compared to the current (less healthy) diet for a reference household. It requires dietary principles to guide the development of the healthy diet pricing instrument and sufficient information about the population’s current intake to inform the current (less healthy) diet tool. The optimal approach includes measures of affordability and requires a standardised measure of household income that can be used for different countries. The feasibility of implementing the protocol in different countries is being tested in New Zealand, Australia and Fiji. The impact of different decision points to address challenges will be investigated in a systematic manner. We will present early insights and results from this work.

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action: Food composition

Reviews and synthesizes evidence to produce evidence-based recommendations on policy actions to improve food composition for NSW Health

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action: Food labeling

Reviews and synthesizes evidence to produce evidence-based recommendations on policy actions to improve food labeling for NSW Health

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action. Seven separate documents across the domains: Food promotion

Reviews and synthesizes evidence to make recommendations on policy actions improve food environments in the area of food promotion for NSW Health

Creating healthy food environments in N.S.W.: A knowledge and evidence synthesis to inform advocacy and action: Food pricing

Reviews and synthesizes evidence to produce evidence-based recommendations on policy actions to improve food pricing for NSW Health

Creating healthy food environments in N.S.W.: A knowledge and evidence synthesis to inform advocacy and action: Food provision

Reviews and synthesizes evidence to produce evidence-based recommendations on policy actions to improve food provision for NSW Health

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action. Seven separate documents across the domains: Food retail

Reviews and synthesizes nutrition policy actions to improve food retail for NSW Health

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action. Seven separate documents across the domains: Overview

Summaries evidence across seven domains of potential food policy action to improve food environments and food supply to prevent obesity for NSW Health

Developing standardized methods to assess cost of healthy and unhealthy (current) diets in Australia

Unhealthy diets contribute at least 14% to Australia's disease burden and are driven by ‘obesogenic’ food environments. Compliance with dietary recommendations is particularly poor amongst disadvantaged populations including low socioeconomic groups, those living in rural/remote areas and Aboriginal and Torres Strait Islanders. The perception that healthy foods are expensive is a key barrier to healthy choices and a major determinant of diet-related health inequities. Available state/regional/local data (limited and non-comparable) suggests that, despite basic healthy foods not incurring GST, the cost of healthy food is higher and has increased more rapidly than unhealthy food over the last 15 years in Australia. However, there were no nationally standardised tools or protocols to benchmark, compare or monitor food prices and affordability in Australia. Globally, we are leading work to develop and test approaches to assess the price differential of healthy and less-healthy (current) diets under the food price module of the International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS). This presentation describes contextualization of the INFORMAS approach to develop standardised Australian tools, survey protocols and data collection and analysis systems. The ‘healthy diet basket’ was based on the Australian Foundation Diet, 1 The ‘current diet basket’ and specific items included in each basket, were based on recent national dietary survey data.2 Data collection methods were piloted. The final tools and protocols were then applied to measure the price and affordability of healthy and less healthy (current) diets of different household groups in diverse communities across the nation. We have compared results for different geographical locations/population subgroups in Australia and assessed these against international INFORMAS benchmarks. The results inform the development of policy and practice, including those relevant to mooted changes to the GST base, to promote nutrition and healthy weight and prevent chronic disease in Australia.

Symposium: Food pricing and affordability of ‘healthy’ versus ‘less healthy’ diets: An international approach to monitoring and surveillance

Symposium co-ordinated by The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) Purpose Global monitoring of the price and affordability of foods, meals and diets is urgently needed. There are major methodological challenges in developing robust, cost-effective, standardized, and policy relevant tools, pertinent to nutrition, obesity, and diet-related non-communicable diseases and their inequalities. There is increasing pressure to take into account environmental sustainability. Changes in price differentials and affordability need to be comparable between and within countries and over time. Robust tools could provide baseline data for monitoring and evaluating structural, economic and social policies at the country/regional and household levels. INFORMAS offers one framework for consideration.