Food references and marketing in popular magazines for children and adolescents in New Zealand. A content analysis

Food marketing is recognized as an important factor influencing children's food preferences and consumption. The purpose of this study was to examine the nature and extent of unhealthy food marketing and non-branded food references in magazines targeted at and popular among children and adolescents 10–17 years in New Zealand. A content analysis was conducted of all food references (branded and non-branded) found in the five magazines with the highest readership among 10–17 year olds, and the three magazines (of which two were already included among the five most popular magazines) targeted to 10–17 year olds. For each of the six magazines one issue per month (n = 72 issues in total) over a one-year period (December 2012–January 2014) was included. All foods referenced were classified into healthy/unhealthy according to the food-based Ministry of Health classification system. Branded food references (30% of total) were more frequent for unhealthy (43%) compared to healthy (25%) foods. Magazines specifically targeted to children and adolescents contained a significantly higher proportion of unhealthy branded food references (72%, n = 51/71) compared to the most popular magazines among children and adolescents (42%, n = 133/317), of which most were targeted to women. ‘Snack items’ such as chocolates and ice creams were marketed most frequently (n = 104; 36%), while ‘vegetables and fruits’ were marketed the least frequently (n = 9; 3%). Direct advertisements accounted for 27% of branded food references and 25% of those featured health or nutrition claims. Both branded and non-branded food references were common within magazines targeted at and popular among children and adolescents, and skewed toward unhealthy foods. This raises concerns about the effectiveness of self-regulation in marketing and emphasizes that government regulations are needed in order to curb children's current potential high exposures to unhealthy food marketing. In addition, magazine editors could take socially responsible editorial positions in regard to healthy eating.

Interventions to improve cultural competency in healthcare: a systematic review of reviews

Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area.

The use of a nursing informatics system as an exemplar to investigate business value of IT in healthcare

Researchers and decision makers in healthcare are taking great interest in clinical practices where there is a high potential to improve healthcare outcomes and reduce costs by incorporating a myriad of technology solutions. However, to date very few, if any of these IS/IT (information systems/information technology) solutions have realised the expected improvements to quality care with the expected cost reductions. This makes the need to evaluate the impact of IT on overall performance of clinical practices i.e. business value of IT a key strategic imperative in healthcare. To address this key need, we propose a comprehensive framework that conceptualises business value of IT in healthcare in different layers. To illustrate the proposed framework, a case study is used, which serves to examine the proposed conceptual model. The exemplar case study is an Australian-made nursing documentation system; an enterprise system that caters for multiple clinical users in acute healthcare contexts and hence provides appropriate richness to validate the proposed model.

A systematic review of reliable and valid tools for the measurement of patient participation in healthcare

INTRODUCTION: Patient participation in healthcare is recognised internationally as essential for consumer-centric, high-quality healthcare delivery. Its measurement as part of continuous quality improvement requires development of agreed standards and measurable indicators. AIM: This systematic review sought to identify strategies to measure patient participation in healthcare and to report their reliability and validity. In the context of this review, patient participation was constructed as shared decision-making, acknowledging the patient as having critical knowledge regarding their own health and care needs and promoting self-care/autonomy. METHODS: Following a comprehensive search, studies reporting reliability or validity of an instrument used in a healthcare setting to measure patient participation, published in English between January 2004 and March 2014 were eligible for inclusion. RESULTS: From an initial search, which identified 1582 studies, 156 studies were retrieved and screened against inclusion criteria. Thirty-three studies reporting 24 patient participation measurement tools met inclusion criteria, and were critically appraised. The majority of studies were descriptive psychometric studies using prospective, cross-sectional designs. Almost all the tools completed by patients, family caregivers, observers or more than one stakeholder focused on aspects of patient-professional communication. Few tools designed for completion by patients or family caregivers provided valid and reliable measures of patient participation. There was low correlation between many of the tools and other measures of patient satisfaction. CONCLUSION: Few reliable and valid tools for measurement of patient participation in healthcare have been recently developed. Of those reported in this review, the dyadic Observing Patient Involvement in Decision Making (dyadic-OPTION) tool presents the most promise for measuring core components of patient participation. There remains a need for further study into valid, reliable and feasible strategies for measuring patient participation as part of continuous quality improvement.

Content architecture applications in healthcare

Healthcare delivery is undergoing significant transformation in the United States. Many hospitals and clinics are utilizing electronic means for maintaining patient records. Implementation of electronic health records is now a prevalent activity at many healthcare organizations. Despite the use of electronic health records by many healthcare organizations, it is still difficult to obtain meaningful information from electronic data pertaining to healthcare. Intelligent content applications organize the data within a company make all the data in the organization searchable and retrievable for faster access. This paper therefore explores SOA (Service oriented architecture) and intelligent content architecture in an attempt to suggest better structures that enable retrieval of related data from myriad sources within a company. While intelligent content applications are being slowly developed for areas such as electronic publishing, its use in healthcare organizations has been limited. This paper discusses applications of intelligent content architecture for the healthcare domain.

Factors influencing compliance to universal precautions in healthcare workers: a systematic literature review

Background: Occupational exposure to blood borne viruses involving hollow bore needles is one of the most commonly reported adverse events affecting staff in the National Health Service in the UK. Universal Precautions Guidelines were originally developed in 1987 in order to minimise the risk of contact with body fluid. Universal precautions not only protect staff against blood borne pathogens but are also considered as an efficient mean to reduce the spread of pathogens from patients to patients via healthcare workers.Aim of the study: The aim of this study was to identify and evaluate the objective evidence on factors influencing healthcare workers compliance to universal precautions through a systematic literature review.Methodology: This systematic review was conducted in 2009 and studies were retrieved through electronic databases, manual journal searches and communications with experts in the field. Studies of cross sectional survey design and observational design were included in the review as they constituted the most commonly used research design evaluating compliance to universal precautions.A quality checklist was developed based on existing assessment criteria.Findings: Studies conducted to ascertain compliance to universal precautions are plentiful but remain of low quality. Sixty studies were retrieved and evaluated for potential inclusion in this study. Four studies met the inclusion criteria. Three were of cross-sectional survey design and one of direct observational design.Conclusions: Uptake of universal precautions remains low despite known benefits. Lack of time, resources and lack of knowledge have been shown as being factors negatively influencing healthcare workers compliance with universal precautions.This paper also highlights the issues surrounding the inclusion of low grade evidence in systematic literature reviews and the implications of reviews including low grade evidence on practice.Type of article: Research paperKeywords: systematic review, universal precautions, standard precautions, compliance, healthcare worker.

Intelligent risk detection in healthcare contexts of hip and knee athroplasty and paediatric congenital heart disease

Rapid increase of service demands in healthcare contexts today requires a robust framework enabled by IT (information technology) solutions as well as real-time service handling in order to ensure superior decision making and successful healthcare outcomes. Contemporaneous with the challenges facing healthcare, we are witnessing the development of very sophisticated intelligent tools and technologies such as Business Analytics techniques. Therefore, it would appear to be prudent to investigate the possibility of applying such tools and technologies into various healthcare contexts to facilitate better risk detection and support superior decision making. The following serves to do this in the context of Total Hip and Knee Arthroplasty and Congenital Heart Disease.

The role of IT governance in generating business value from IT investments in healthcare: lessons from an Australian experience

Digitizing the core processes of healthcare delivery is looked at as a solution to control the escalating costs without compromising quality or patient outcomes. However, to date the business value of such IT solutions remains elusive, especially in view of the high failure rate of many solutions coupled with the high user resistance. The uniqueness of the healthcare industry makes measuring the business value of IT a complex missions, yet it is the thesis of this research that such an activity is an essential first step if we are to realise the full potential of IT in healthcare. The role IT governance can play is of high importance to generate business value from IT investments in healthcare. This is investigated using an integrative model that is proffered to conceptualise the business value of IT in healthcare. This conceptual model is then used to guide an exploratory case study based at a leading private healthcare provider in Melbourne-Australia.

A framework for mixed-type multi-outcome prediction with applications in healthcare

Health analysis often involves prediction of multiple outcomes of mixed-type. Existing work is restrictive to either a limited number or specific outcome types. We propose a framework for mixed-type multi-outcome prediction. Our proposed framework proposes a cumulative loss function composed of a specific loss function for each outcome type - as an example, least square (continuous outcome), hinge (binary outcome), poisson (count outcome) and exponential (non-negative outcome). Tomodel these outcomes jointly, we impose a commonality across the prediction parameters through a common matrix-Normal prior. The framework is formulated as iterative optimization problems and solved using an efficient Block coordinate descent method (BCD). We empirically demonstrate both scalability and convergence. We apply the proposed model to a synthetic dataset and then on two real-world cohorts: a Cancer cohort and an Acute Myocardial Infarction cohort collected over a two year period. We predict multiple emergency related outcomes - as example, future emergency presentations (binary), emergency admissions (count), emergency length-of-stay-days (non-negative) and emergency time-to-next-admission-day (non-negative). Weshow that the predictive performance of the proposed model is better than several state-of-the-art baselines.

History of marketing in India

Contemporary concepts and practices of marketing, and the ideologies which impel these, originate from the social and economic contexts of the West, particularly the United States and Europe (Ellis et al., 2011; Eckhardt et al., 2013). As a consequence of this Western dominance, the marketing discipline became permeated with values such as individualism and rationalism (Ellis et al., 2011). The Eurocentrism of much of marketing theory has resulted in knowledge pertinent to contexts such as India being overlooked (Varman and Saha, 2009; Varman and Sreekumar, 2015). In an early paper that appeared in the Journal of Marketing, Westfall and Boyd, Jr. (1960) suggested that marketing practices in India were not sufficiently ‘developed’, and called for a ‘modernization’ of marketing in India. In response to such criticism, marketing academics in India adopted theories and practices of marketing from the West, especially the US. Not surprisingly, these theories and practices were often far removed from the realities of the Indian economy and consumers (Varman et al., 2011). This is particularly ironic because India, like many other parts of the world, has a rich history of markets and marketing. There is clearly a need to bridge this gap in our knowledge and understanding about the rest of the world. This chapter on history of marketing in India addresses this lacuna in the discipline

Collaboration and co-production of knowledge in healthcare: opportunities and challenges

Over time there has been a shift, at least in the rhetoric, from a pipeline conceptualisation of knowledge implementation, to one that recognises the potential of more collaboration, co-productive approaches to knowledge production and use. In this editorial, which is grounded in our research and collective experience, we highlight both the potential and challenge with collaboration and co-production. This includes issues about stakeholder engagement, governance arrangements, and capacity and capability for working in a co-productive way. Finally, we reflect on the fact that this approach is not a panacea, but is accompanied by some philosophical and practical challenges.