Background: Dietary factors are among the largest and costliest drivers of chronic diseases in England. As a response, the government implements a range of population interventions to promote healthy diets by targeting food environments. Objectives: This study aimed to conduct a systematic review of the effectiveness, cost-effectiveness and policy process of real-world evaluations of national and state policies on improving food environments, with a focus on whether they were regulatory, voluntary or partnership approaches. Data sources: Fourteen relevant English-language databases were searched in November 2020 for studies published between 2010 and 2020. Methods: Six separate evidence reviews were conducted to assess the evidence of effectiveness, cost-effectiveness and policy processes of policies to improve food environments. Results: A total of 483 primary research evaluations and 14 evidence syntheses were included. The study reveals considerable geographic, methodological and other imbalances across the literature, with, for example, 81% of publications focusing only on 12 countries. The systematic reviews also reveal the effectiveness and cost-effectiveness of reviewed regulatory approaches designed to improve health, consumer behaviour and food environment outcomes while public–private partnerships and voluntary approaches to improve diets via reformulation, advertising and promotion restrictions or other changes to the environment were limited in their effectiveness and cost-effectiveness. The study also revealed key enabling and impeding factors across regulatory, voluntary and public–private partnership approaches. Conclusion: From the available evidence reviewed, this study finds that regulatory approaches appear most effective at improving the food environment, and voluntary agreements and partnerships have limited effectiveness. These findings should be carefully considered in future public health policy development, as should the findings of geographic imbalance in the evidence and inadequate representation of equity dimensions across the policy evaluations. We find that food policies are at times driven by factors other than the evidence and shaped by compromise and pragmatism. Food policy should be first and foremost designed and driven by the evidence of greatest effectiveness to improve food environments for healthier diets. Limitations: This was a complex evidence synthesis due to its scope and some policy evaluations may have been missed as the literature searches did not include specific policy names. The literature was limited to studies published in English from 2010 to 2020, potentially missing studies of interest. Future work: Priorities include the need for guidance for appraising risk of bias and quality of non-clinical studies, for reporting policy characteristics in evaluations, for supporting evaluations of real-world policies equitably across geographic regions, for capturing equity dimensions in policy evaluations, and for guideline development for quality and risk of bias of policy evaluations. Study registration: This study is registered as PROSPERO CRD42020170963. Funding: This award project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR128607) and is published in full in Public Health Research; Vol. 12, No. 8. See the NIHR Funding and Awards website for further award information.

Background: Practical links between health systems and health security are historically prevalent, but the conceptual links between these fields remain under explored, with little on health system strengthening. The need to address this gap gains relevance in light of the COVID-19 pandemic as it demonstrated a crucial relationship between health system capacities and effective health security response. Acknowledging the importance of developing stronger and more resilient health systems globally for health emergency preparedness, the WHO developed a Health Systems for Health Security framework that aims to promote a common understanding of what health systems for health security entails whilst identifying key capacities required.Methods/ results: To further explore and analyse the conceptual and practical links between health systems and health security within the peer reviewed literature, a rapid scoping review was carried out to provide an overview of the type, extent and quantity of research available. Studies were included if they had been peer-reviewed and were published in English (seven databases 2000 to 2020). 343 articles were identified, of those 204 discussed health systems and health security (high and medium relevance), 101 discussed just health systems and 47 discussed only health security (low relevance). Within the high and medium relevance articles, several concepts emerged, including the prioritization of health security over health systems, the tendency to treat health security as exceptionalism focusing on acute health emergencies, and a conceptualisation of security as ‘state security’ not ‘human security’ or population health.Conclusion: Examples of literature exploring links between health systems and health security are provided. We also present recommendations for further research, offering several investments and/or programmes that could reliably lead to maximal gains from both a health system and a health security perspective, and why these should be explored further. This paper could help researchers and funders when deciding upon the scope, nature and design of future research in this area. Additionally, the paper legitimises the necessity of the Health Systems for Health Security framework, with the findings of this paper providing useful insights and evidentiary examples for effective implementation of the framework.

Untreated dental caries is the most frequent childhood chronic disease worldwide. Silver diamine fluoride (SDF) offers a safe and effective alternative treatment, especially for children. To inform the dental community about the efficacy of SDF in community dental caries programs and to advocate for its use as an affordable and equitable approach to promote health and well-being within the dental setting. A summary of the literature shared during a webinar about the use and efficacy of SDF in community dental programs hosted by the Oral Health Working Group of the World Federation of Public Health Associations RESULTS: Based on the traditional "drill-and-fill" approach, the current treatment for severe caries is associated with pain, fear, and poor oral health outcomes in later life. Innovative approaches to prevent and control caries are needed. SDF offers an alternative treatment option for caries. It is a practical, affordable, and acceptable option for caries treatment, eliminating the need for general anaesthetic in young children, and improving long-term oral health outcomes. SDF can improve oral health outcomes for community members, especially for individuals from low-socioeconomic settings.

Purpose: The current pilot study explored food insecurity, food waste, food related behaviours and cooking confidence of UK consumers following the COVID-19 lockdown.Design/methodology/approach: Data were collected from 473 UK-based consumers (63% female) in March 2020. A cross-sectional online survey measured variables including food insecurity prevalence, self-reported food waste, food management behaviours, confidence and frequency of use of a range of cooking methods, type of food eaten (ultra-processed, semi-finished, unprocessed) and packaging type foods are purchased in.Findings: 39% of participants have experienced some food insecurity in the last 12 months. Being younger, having a greater BMI and living in a smaller household were associated with food insecurity. Green leaves, carrots, potatoes and sliced bread are the most wasted of purchased foods. Polenta, green leaves and white rice are the most wasted cooked foods. Food secure participants reported wasting a smaller percentage of purchased and cooked foods compared to food insecure participants. Overall, participants were most confident about boiling, microwaving and stir-frying and least confident with using a pressure cooker or sous vide. Food secure participants were more confident with boiling, stir-frying, grilling and roasting than insecure food participants.Practical implications: This has implications for post lockdown policy, including food policies and guidance for public-facing communications.Originality/value: We identified novel differences in self-report food waste behaviours and cooking confidence between the food secure and insecure consumers and observed demographics associated with food insecurity.

Objective: To explore the #SugarTax debate on Twitter to assess actors involved, their connections and the topics being discussed during the implementation and first anniversary of the UK Soft Drink Industry Levy.Design: The structure of the #SugarTax debate on Twitter was assessed using social network analysis. The actors involved, their connections and the topics of discussion taking place were also explored using content, sentiment and thematic analyses.Setting: Twitter between 2017 and 2019.Participants: Twitter users engaging in discussions relating to the hashtag ‘SugarTax’.Results: Tweets (n5366) posted between 5 August 2017 and 7 May 2019 containing #SugarTax were downloaded from Twitter using Network Overview for Discovery and Exploration in Excel. The network included 1883 users, with 686 unique edges and 4679 edges with duplicates. The majority of tweets were negative in sentiment, when assessed by both automatic (64 %,n141) and manual sentiment analysis (52 %,n115) methods. Nine key themes were identified and grouped into two groups according to ‘support for a sugar or SSB tax’ or ‘opposition for a sugar or SSB tax’.Conclusions: Twitter was used as a platform for debating the benefits and limitations of sugar-sweetened beverage taxes. The findings indicate that numerous actors are involved in the debates on Twitter, with advocates and lobbyists using the platform to raise support for their campaigns and reshape public perceptions. The findings and the methods used may be of interest to policymakers as well as to academics and members of the public looking to explore and engage in policy debates.