Rethinking policies for the retention of allied health professionals in rural areas : a social relations approach

Objective: Retaining allied health professionals in rural areas is a recognised problem. Generally the literature has concentrated on three elements: practitioner needs, community needs and organisational needs. There has been little attempt to focus other types of social relations in which health practitioner retention and recruitment takes place. The aim of this paper is to question the present dominant hierarchical approach taken in relation to the retention of allied health professionals in rural localities.

Methods: The data derives from a survey in Southwest Victoria, Australia. The sample was purposive rather than representative as it was intended to be exploratory in nature rather than definitive.

Results: The data indicates that there is a greater tendency for allied health professionals in private practice to be retained in rural areas than those in the public sector.

Conclusion: The paper concludes by raising some questions about the pertinence of present models for regional health initiatives since they are locked into a bureuacratic model where relationships are hierarchical and asymmetrically controlled.

Sport development, systems, policies and pathways : an introduction to the special issue

Fundamentally sport development is about participation and promoting the opportunities and benefits of participation. Participation in sport and physical activity spans a wide range of contexts including the wholesomeness associated with the freedom of children’s play to the modification of sport to allow children to be children a little longer. The cycle of participation continues to junior and youth sport, where the rules, regulations and traditions of a sport become the foundation to protecting the “institution” of sport, to participation in senior competitions and ultimately, to elite and professional sport. Sport development research and practice therefore is concerned with all these manifestations of the sport experience. It logically follows that the purview of sport development is quite large and potentially complex. Moreover, it is possible to identify at least five themes that could be used to categorise sport development research. These themes include; policy, development through sport, development of sport, future patterns of sport delivery and marketing in terms of the relationship between professional sport and participation.

Obesity prevention : the role of policies, laws and regulations

The commercial drivers of the obesity epidemic are so influential that obesity can be considered a robust sign of commercial success – consumers are buying more food, more cars and more energy-saving machines. It is unlikely that these powerful economic forces will change sufficiently in response to consumer desires to eat less and move more or corporate desires to be more socially responsible. When the free market creates substantial population detriments and health inequalities, government policies are needed to change the ground rules in favour of population benefits.
Concerted action is needed from governments in four broad areas: provide leadership to set the agenda and show the way; advocate for a multi-sector response and establish the mechanisms for all sectors to engage and enhance action; develop and implement policies (including laws and regulations) to create healthier food and activity environments, and; secure increased and continued funding to reduce obesogenic environments and promote healthy eating and physical activity.
Policies, laws and regulations are often needed to drive the environmental and social changes that, eventually, will have a sustainable impact on reducing obesity. An 'obesity impact assessment' on legislation such as public liability, urban planning, transport, food safety, agriculture, and trade may identify 'rules' which contribute to obesogenic environments. In other areas, such as marketing to children, school food, and taxes/levies, there may be opportunities for regulations to actively support obesity prevention. Legislation in other areas such as to reduce climate change may also contribute to obesity prevention ('stealth interventions'). A political willingness to use policy instruments to drive change will probably be an early hallmark of successful obesity prevention.

The division of labor, capital, communication technology and economic growth : the case of China 1952–99

The implications of the division of labor, capital, and technology for economic growth have long been a fundamental issue in development economics. This paper employs the bounds testing approach to cointegration to examine the relationship between the division of labor, capital accumulation, communication technology, and economic growth for China over the period 1952–99. We find that in the long run, capital stock and the division of labor both have statistically significant positive effects on growth, while in the short run the effects are not significantly positive. Telecommunication technology, rather surprisingly, has a statistically insignificant impact on growth both in the long run and in the short run. Our findings indicate that there exists a long run equilibrium relationship between capital and the division of labor on the one hand, and economic growth on the other, thereby lending support to the division of labor theory of growth.

People, places and policies – trying to account for health inequalities in impoverished neighbourhoods

Objective : We consider associations between individual, household and area-level characteristics and self-reported health.
Method : Data is taken from baseline surveys undertaken in 13 socio-economically disadvantaged neighbourhoods in Victoria (n=3,944). The neighbourhoods are sites undergoing Neighbourhood Renewal (NR), a State government initiative redressing place-based disadvantage.
Analysis :This focused on the relationship between area and compositional factors and self-reported health. Area was coded into three categories; LGA, NR residents living in public housing (NRPU) and NR residents who lived in private housing (NRPR). Compositional factors included age, gender, marital status, identifying as a person with a disability, level of education, unemployment and receipt of pensions/benefits.
Results : There was a gradient in socio-economic disadvantage on all measures. People living in NR public housing were more disadvantaged than people living in NR private housing who, in turn, were more disadvantaged than people in the same LGA. NR public housing residents reported the worst health status and LGA residents reported the best.
Conclusions : Associations between compositional characteristics of disability, educational achievement and unemployment income and poorer self-reported health were shown. They suggested that area characteristics, with housing policies, may be contributing to differences in self-reported health at the neighbourhood level.
Implications : The clustering of socio-economic disadvantage and health outcomes requires the integration of health and social support interventions that address the circumstances of people and places.

Examination of selected national policies towards mandatory folic acid fortification

The purpose of this paper is to present an examination of the contrasting policies towards mandatory folic acid fortification in six countries from different regions of the world. Three questions are addressed: 1) What is the policy of the country? 2) Why was the policy adopted? 3) What lessons have been learned? Policy contrasts among countries were assessed as reflecting different interpretations of the potential risks and benefits associated with folic acid fortification. Although commonalities were identified, it was considered unlikely that there could be a standard policy response for all countries. Instead, a country-by-country policy response based on national circumstances is indicated.

The effects of financial constraints on corporate policies in Australia

We jointly study the impact of financial constraints on Australian companies' investment decisions and demand for liquidity. By examining a large sample of Australian firms over the period 1990–2003, we find that financial constraints not only reduce the sensitivity of investment to the availability of internal funds, but also increase the responsiveness of cash holdings to internally generated cash flows. Further analysis shows that the impact of financial constraints varies across different cash flow states; that is, financial constraints have a small effect on corporate investment and cash policies when cash flows are positive. In contrast, the severity of constraints is high in negative cash flow years in which the cost disadvantage of external finance coincides with deteriorating operating performance.

The effect of smoke-free policies on revenue in bars in Tasmania, Australia

Objective: To examine the impact of smoke-free policies on revenue in Tasmanian bars.

Method: Monthly sales turnover from January 2002 to March 2007, provided by the Australian Bureau of Statistics was analysed. There were two outcome measures: (1) the ratio of monthly bar sales turnover in Tasmania to monthly bar sales turnover in four other Australian states, and (2) the ratio of monthly bar turnover to monthly retail turnover in Tasmania. Linear regression was used to assess the impact of the smoke-free policy on expenditure.

Results: The smoke-free policy had no effect on sales turnover.

Conclusion: The smoke-free policy protects hospitality workers and patrons from exposure to secondhand smoke and has had no adverse effect on sales turnover.

The effect of smokefree policies on electronic gaming machine expenditure in Victoria, Australia

Objective: To examine the impact of smoke-free policies in Victorian gambling venues on electronic gaming machine (EGM) expenditure.

Method: Monthly EGM expenditure from July 1998 to December 2005, provided by the Victorian Commission for Gambling Regulation and the Office of the Liquor and Gambling Commissioner in South Australia, was analysed. The outcome measure was the ratio of monthly expenditure for Victoria to monthly expenditure in South Australia. Intervention analysis and autoregressive integrated moving average modelling were used to assess the impact of the smoke-free policy on expenditure.

Results: The smoke-free policy resulted in an abrupt, long-term decrease in the level of EGM expenditure. The mean level of monthly expenditure decreased by approximately 14%.

Conclusion: The smoke-free policy not only protects hospitality workers and patrons from exposure to secondhand smoke but has also had an impact on slowing gambling losses.

Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry

Objective: To compare the quality and funding source of studies concluding a negative economic impact of smoke-free policies in the hospitality industry to studies concluding no such negative impact.

Data sources: Researchers sought all studies produced before 31 August 2002. Articles published in scientific journals were located with Medline, Science Citation Index, Social Sciences Citation Index, Current Contents, PsychInfo, Econlit, and Healthstar. Unpublished studies were located from tobacco company websites and through internet searches.

Study selection: 97 studies that made statements about economic impact were included. 93% of the studies located met the selection criteria as determined by consensus between multiple reviewers.

Data extraction: Findings and characteristics of studies (apart from funding source) were classified independently by two researchers. A third assessor blind to both the objective of the present study and to funding source also classified each study.

Data synthesis: In studies concluding a negative impact, the odds of using a subjective outcome measure was 4.0 times (95% confidence interval (CI) 1.4 to 9.6; p = 0.007) and the odds of not being peer reviewed was 20 times (95% CI 2.6 to 166.7; p = 0.004) that of studies concluding no such negative impact. All of the studies concluding a negative impact were supported by the tobacco industry. 94% of the tobacco industry supported studies concluded a negative economic impact compared to none of the non-industry supported studies.

Conclusion: All of the best designed studies report no impact or a positive impact of smoke-free restaurant and bar laws on sales or employment. Policymakers can act to protect workers and patrons from the toxins in secondhand smoke confident in rejecting industry claims that there will be an adverse economic impact.