Analysis of the corporate political activity of major food industry actors in Fiji

BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of mortality in Fiji, a middle-income country in the Pacific. Some food products processed sold and marketed by the food industry are major contributors to the NCD epidemic, and the food industry is widely identified as having strong economic and political power. However, little research has been undertaken on the attempts by the food industry to influence public health-related policies and programs in its favour. The "corporate political activity" (CPA) of the food industry includes six strategies (information and messaging; financial incentives; constituency building; legal strategies; policy substitution; opposition fragmentation and destabilisation). For this study, we aimed to gain a detailed understanding of the CPA strategies and practices of major food industry actors in Fiji, interpreted through a public health lens.

METHODS AND RESULTS: We implemented a systematic approach to monitor the CPA of the food industry in Fiji for three months. It consisted of document analysis of relevant publicly available information. In parallel, we conducted semi-structured interviews with 10 stakeholders involved in diet- and/or public health-related issues in Fiji. Both components of the study were thematically analysed. We found evidence that the food industry adopted a diverse range of strategies in an attempt to influence public policy in Fiji, with all six CPA strategies identified. Participants identified that there is a substantial risk that the widespread CPA of the food industry could undermine efforts to address NCDs in Fiji.

CONCLUSIONS: Despite limited public disclosure of information, such as data related to food industry donations to political parties and lobbying, we were able to identify many CPA practices used by the food industry in Fiji. Greater transparency from the food industry and the government would help strengthen efforts to increase their accountability and support NCD prevention. In other low- and middle-income countries, it is likely that a systematic document analysis approach would also need to be supplemented with key informant interviews to gain insight into this important influence on NCD prevention.

Evaluation of the environments for health framework

Environments for Health, Five Years On…
Since its release in 2001, Victoria’s Environments for Health Municipal Public Heath Planning Framework, has represented a leading edge approach to supporting quality public health planning at the local government level.

In 2006 the Department of Human Services appointed an external evaluation team from Deakin and Melbourne Universities to assess the introduction of the Environments for Health framework to municipal public health planning and to make recommendations for its future direction.

The evaluation aimed to determine the extent to which Environments for Health and related implementation activities had:

* been incorporated by local governments in their policies and practices
* created greater opportunities for health gain, and
* been supported effectively by the Department of Human Services and other stakeholders

The evaluation project involved participation from a broad range of key stakeholders, including all local Councils within Victoria. Data collection covered four distinct stages - document analysis, key informant interviews, state-wide survey of practitioners, and council and stakeholder forums, all with opportunities for input to the evaluation.

Investigation of the factors responsible for the superior performance of male students in standardised testing at one primary school

The project set out to investigate one primary school where, for four years or more, boys have outperformed girls in standardized Year 3 and 5 Basic Skills Tests in literacy and numeracy, which contradicts general findings on male and female performance in standardized literacy and numeracy testing. The school placed a heavy emphasis on literacy programs, which appear to be making a difference to the boys. Over time, there has been a slight improvement in boys’ literacy performance but the greatest area of growth is generally boys’ numeracy, rather than boys’ literacy.

Further aims of the study were to isolate school-based factors, which are potentially responsible for this phenomenon, from community-based factors and to explore the possibility that, rather than boys being advantaged, girls were actually being disadvantaged by practices at the school. The approach adopted by the research team employed intensive case-study methods and ethnographic approaches, including interviews, document analysis, and structured and unstructured observation of a range of school activities.

This paper describes how the school has transformed itself, the effects that this has had upon the teaching and learning environment and the results that have been achieved in the key areas of numeracy and literacy.

Australian elite athlete development : an organisational perpective

The purpose of this paper is to examine and map the process of Australian elite athlete development from an organisational perspective, that of 35 national sporting organisations (NSOs). Research on elite development has focused on the significance of economic and cultural factors (macro-level studies) and the role of sport science and athletes’ close environment (micro-level studies) in fostering success. In an effort to depict elite athlete development processes in a more inclusive way, this paper offers an evaluation of the ways elite athletes are nurtured from an Australian NSOs perspective adopting a meso-level approach (e.g., programs). The study is based on a document analysis examining 74 annual reports from 35 NSOs over a period of four years, before and after the Sydney Olympic Games and offers a generic framework of the Australian elite athlete development process. The resulting framework shows that various interested groups are involved with nurturing elite athletes through either initiating or implementing specially designed programs or other strategies that cultivate success, and helps broaden the definition of elite development. The implications of successful elite athlete development include increased finances and public profile for sports as well as the creation of pathways to increase interest in sport.

Investigating the pedagogical process in physical education teacher education

The study investigated two main questions: the first focused on the factors that enabled and constrained student teachers' engagement of a socially critical pedagogy in physical education teacher education (PETE); the second centered on gaining insight into the usefulness of knowledgeability as a concept for analysing student teachers engagement of a socially critical pedagogy. At the time of writing this thesis empirical analyses of socially critical pedagogies in physical education were rare in the educational literature. The study provided an alternative way of analysing student teachers’ engagement of a socially critical pedagogy in PETE. Alternative in that it avoided recycling and reproducing the dualism between agency and structure (Aronowitz and Giroux, 1985) that is prevalent in much of the physical education literature. Conversational interviews were conducted with four student teachers and their teacher educators throughout the duration of a one-semester PETE unit in an Australian university. Observations were made of the lecture and practical sessions and a document analysis was conducted of all unit learning resources. The analytical frame used in the study was structuration theory (Giddens, 1979, 1984). This framework was useful because it gave primacy to the duality of structure which recognised ‘the structural properties of social systems are both the medium and outcome of practices that constitute those systems’ (Giddens, 1979, p.69). The pedagogical intentions of the teacher educator co-ordinating the PETE unit were to change the orientations of the student teachers towards primary school physical education by encouraging them to adopt different ‘lenses’ through which to examine pedagogical practices. These ‘lenses’ highlighted the questions central to those with socio-critical intentions, eg. power, social injustice and diversity. Data generated from conversations with, and observations of, the student teachers, indicated that the actualisation of the teacher educator's intentions were somewhat limited. Despite this, adopting structuration theory as the explanatory framework for the study proved generative at a number of levels. Broadly, structuration theory was useful because it highlighted the way that student teachers' engagement with a socially critical pedagogy is contingent upon particular (idiosyncratic) dialectics of agency and structure. Using the duality of structure as an analytical tool illustrated the way student teachers' were influenced by structural factors as well as the way these structural factors were in turn constituted by the action of the student teachers. Also, by utilising structuration theory as an explanatory framework, the concept of knowledgeability was identified as a useful concept for analysing student teachers' engagement with a socially critical pedagogy in PETE. What is more, the study highlighted the reflexivity of the self and social knowledge, both characteristics of late modernity, as being integral to the way the student teachers engaged with the socially critical pedagogy of EAE400. Not only did the study highlight the reflexivity of the self but it also provided insight into the reflexivity of social knowledge. Much of the socially critical work in physical education implicitly adopts a linear approach to change. Given the findings of the study it might be useful for future developments to consider change as circular. The thesis concludes by suggesting that given the reflexivity of social knowledge, socially critical perspectives might be more readily engaged if the PETE content was incorporated into student teachers existing knowledge frameworks rather than viewed as a replacement for such frameworks.

It's all a bit wishy washy : the challenge of building partnerships for effective mental health evaluation

Mental wellbeing and social connectedness is a key health priority in Victoria. Actions and interventions that may contribute to the promotion of community level mental wellbeing and social connectedness often occurs in other, non-health sectors. Including evidence from these sectors in evaluations of community based interventions around mental wellbeing and social connectedness is important to ensure comprehensive evaluation, and the development of best practice in this health priority area. However, published evaluation material of community based interventions around this health topic is limited, and rarely captures information from non-health sectors. This pilot study investigated the capacity of health promotion practitioners and other key stakeholders working in this area in Victoria to undertake evaluation of community based mental wellbeing and social connectedness interventions, issues and barriers faced in evaluation, and practitioners’ needs to be able to conduct effective and comprehensive evaluations.

Qualitative methods including semi-structure interviews and document analysis were used. Data was coded and analysed inductively, and key themes developed.

Results indicate that evaluating such interventions is challenging for practitioners due to the broad nature of the topic, and the measurement tools available. Many practitioners would like to conduct more comprehensive evaluation and include evidence from other sectors. Managerial and organizational support to develop partnerships both within the health sector and inter-sectorally was identified as a need in order to develop evaluation skills and facilitate more comprehensive evidence gathering.

This study underscores the importance of inter-sectoral partnerships for developing best evidence-based practice in community health. Partnerships are necessary for conducting comprehensive and effective evaluation to contribute to the evidence base. However, developing effective partnerships is challenging, and acts as a barrier to effective evaluation in a key health area for some community health practitioners. The findings also highlight an agenda for more action by managers to facilitate the development of relevant inter-sectoral partnerships.

Discursive recontextualization in a public health setting

The authors discuss discursive recontextualization as a process of discursive change in which stable referents may be recombined. As such, discursive recontextualization recognizes the interplay of both stability and instability without necessarily privileging the latter. Drawing on intertextual document analysis of a series of public reports published in the wake of a major health policy initiative in Victoria, Australia— Health to 2050—the authors identify a discursive pattern in which descriptions of a disaggregation from large Health Care Networks to smaller Metropolitan Health Services echo those of an earlier aggregation of individual hospitals into the Health Care Networks. The authors suggest that future research into discourse and organizational change will benefit from greater attention to stabilization and such recontextualization as well as to fluidity and instability. They examine implications for change agents and for researchers in the field.

Scaling up community-based obesity prevention in Australia : background and evaluation design of the health promoting communities : being active eating well initiative

Background : There is only limited evidence available on how best to prevent childhood obesity and community-based interventions hold promise, as several successful interventions have now been published. The Victorian Government has recently funded six disadvantaged communities across Victoria, Australia for three years to promote healthy eating and physical activity for children, families, and adults in a community-based participatory manner. Five of these intervention communities are situated in Primary Care Partnerships and are the subject of this paper. The interventions will comprise a mixture of capacity-building, environmental, and whole-of-community approaches with targeted and population-level interventions. The specific intervention activities will be determined locally within each community through stakeholder and community consultation. Implementation of the interventions will occur through funded positions in primary care and local government. This paper describes the design of the evaluation of the five primary care partnership-based initiatives in the 'Go for your life' Health Promoting Communities: Being Active Eating Well (HPC:BAEW) initiative.

Methods/Design : A mixed method and multi-level evaluation of the HPC:BAEW initiative will capture process, impact and outcome data and involve both local and state-wide evaluators. There will be a combined analysis across the five community intervention projects with outcomes compared to a comparison group using a cross-sectional, quasi-experimental design. The evaluation will capture process, weight status, socio-demographic, obesity-related behavioral and environmental data in intervention and comparison areas. This will be achieved using document analysis, paper-based questionnaires, interviews and direct measures of weight, height and waist circumference from participants (children, adolescents and adults).

Discussion : This study will add significant evidence on how to prevent obesity at a population level in disadvantaged and ethnically diverse communities. The outcomes will have direct influence on policy and practice and guide the development and implementation of future obesity prevention efforts in Australia and internationally.

A decade of MERGA theses

The MERGA website has a list of the titles of the last 10 years of Australasian mathematics education Masters and Doctoral theses, with linked abstracts. After a discussion about the socially-determined nature of document analysis, this paper reports the results of an interpretive document analysis of the web page and the pages of abstracts, with a focus on
(a) numbers of theses, by year and by institution;
(b) methodological approaches used;
(c) countries where data were collected; and
(d) theses topics. Begle’s (1979) framework of mathematics education domains is used to categorise 3 descriptors for each thesis.

Increasing community capacity to prevent childhood obesity : challenges, lessons learned and results from the Romp & Chomp intervention

Background
Obesity is a major public health issue; however, only limited evidence is available about effective ways to prevent obesity, particularly in early childhood. Romp & Chomp was a community-wide obesity prevention intervention conducted in Geelong Australia with a target group of 12,000 children aged 0-5 years. The intervention had an environmental and capacity building focus and we have recently demonstrated that the prevalence of overweight/obesity was lower in intervention children, post-intervention. Capacity building is defined as the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion and the aim of this study was to determine if the capacity of the Geelong community, represented by key stakeholder organisations, to support healthy eating and physical activity for young children was increased after Romp & Chomp.

Methods
A mixed methods evaluation with three data sources was utilised. 1) Document analysis comprised assessment of the documented formative and intervention activities against a capacity building framework (five domains: Partnerships, Leadership, Resource Allocation, Workforce Development, and Organisational Development); 2) Thematic analysis of key informant interviews (n = 16); and 3) the quantitative Community Capacity Index Survey.

Results
Document analysis showed that the majority of the capacity building activities addressed the Partnerships, Resource Allocation and Organisational Development domains of capacity building, with a lack of activity in the Leadership and Workforce Development domains. The thematic analysis revealed the establishment of sustainable partnerships, use of specialist advice, and integration of activities into ongoing formal training for early childhood workers. Complex issues also emerged from the key informant interviews regarding the challenges of limited funding, high staff turnover, changing governance structures, lack of high level leadership and unclear communication strategies. The Community Capacity Index provided further evidence that the project implementation network achieved a moderate level of capacity.

Conclusions
Romp & Chomp increased the capacity of organisations, settings and services in the Geelong community to support healthy eating and physical activity for young children. Despite this success there are important learnings from this mixed methods evaluation that should inform current and future community-based public health and health promotion initiatives.

Trial Registration Number: ANZCTRN12607000374460

The early years framework - where is the science?

Australia is embarking on the implementation of Early Years Frameworks at both national and state levels and it is a significant that we investigate the place of science education for our children 0-5 years of age. Where does science education fit into these frameworks? A document analysis of both the national (Australia) and state frameworks (Victoria) will highlight the guidance given to early years practitioners in terms of science education. By comparison, many countries in the western world have trialled and implemented early childhood frameworks. Through an investigation of the frameworks in place in England, a comparative analysis of the introduction of science in early childhood settings is provided. The research in England was comprised of case studies of four centres and data collected through interview from stakeholders from government and educational fields. The research will show how, with a slight change in wording, we can be more inclusive of science as a natural part of early childhood education.

Satellite dialysis nursing : technology, caring and power

Aim. This paper is a report of an exploration of nurses’ perceptions of the quality of satellite dialysis care and how aspects of power that influenced quality nursing care.

Background. In Australia, the majority of people living with established kidney failure undertake haemodialysis in nurse-run satellite dialysis units. Haemodialysis nurses provide the majority of care, and their perceptions of what constitutes quality nursing care may influence their care of the person receiving haemodialysis.

Method. A critical ethnographic study was conducted where data were collected from one metropolitan satellite dialysis unit in Australia over a 12-month period throughout 2005. The methods included non-participant observation, interviews, document analysis, reflective field notes and participant feedback.

Findings. Three theoretical constructs were identified: ‘What is quality?’, ‘What is not quality?’ and What influences quality?’ Nurses considered technical knowledge, technical skills and personal respect as characteristics of quality. Long-term blood pressure management and arranging transport for people receiving dialysis treatment were not seen to be priorities for quality care. The person receiving dialysis treatment, management, nurse and environment were considered major factors determining quality dialysis nursing care.

Conclusion. Aspects of power and oppression operated for nurses and people receiving dialysis treatment within the satellite dialysis context, and this environment was perceived by the nurses as very different from hospital dialysis units.

It's here! Are we ready? Five case studies of health promotion practices that address climate change from within Victorian health care settings

Issue addressed: Climate changes and environmental degradation caused by anthropogenic activities are having an irrefutable impact on human health. The critical role played by health promotion in addressing environmental challenges has a history in seminal charters − such as the Ottawa Charter for Health Promotion − that explicitly link human well-being with the natural environment. The lack of documented practice in this field prompted an investigation of health promotion practice that addresses climate change issues within health care settings.

Methods: This qualitative study involved five case studies of Victorian health care agencies that explicitly identified climate change as a priority. Individual and group interviews with ten health promotion funded practitioners as well as document analysis techniques were used to explore diverse practices across these rural, regional and urban health care agencies.

Results: Health promotion practice in these agencies was oriented toward: active and sustainable transport; healthy and sustainable food supply; mental health and community resilience; engaging vulnerable population groups such as women; and organisational development.

Conclusion: Despite differences in approach, target population and context, the core finding was that health promotion strategies, competencies and frameworks were transferable to action on climate change in these health care settings.

Computable social patterns from sparse sensor data

We present a computational framework to automatically discover high-order temporal social patterns from very noisy and sparse location data. We introduce the concept of social footprint and present a method to construct a codebook, enabling the transformation of raw sensor data into a collection of social pages. Each page captures social activities of a user over regular time period, and represented as a sequence of encoded footprints. Computable patterns are then defined as repeated structures found in these sequences. To do so, we appeal to modeling tools in document analysis and propose a Latent Social theme Dirichlet Allocation (LSDA) model - a version of the Ngram topic model in [6] with extra modeling of personal context. This model can be viewed as a Bayesian clustering method, jointly discovering temporal collocation of footprints and exploiting statistical strength across social pages, to automatically discovery high-order patterns. Alternatively, it can be viewed as a dimensionality reduction method where the reduced latent space can be interpreted as the hidden social 'theme' - a more abstract perception of user's daily activities. Applying this framework to a real-world noisy dataset collected over 1.5 years, we show that many useful and interesting patterns can be computed. Interpretable social themes can also be deduced from the discovered patterns.

Unsafe abortion as a birth control method: maternal mortality risks among unmarried Cambodian migrant women on the Thai-Cambodia border

Reproductive health research and policies in Cambodia focus on safe motherhood programs particularly for married women, ignoring comprehensive fertility regulation programs for unmarried migrant women of reproductive age. Maternal mortality risks arising due to unsafe abortion methods practiced by unmarried Cambodian women, across the Thai-Cambodia border, can be considered as a public health emergency. Since Thailand has restrictive abortion laws, Cambodian migrant women who have irregular migration status in Thailand experimented with unsafe abortion methods that allowed them to terminate their pregnancies surreptitiously. Unmarried migrant women choose abortion as a preferred birth control method seeking repeat “unsafe” abortions instead of preventing conception. Drawing on the data collected through surveys, in-depth interviews, and document analysis in Chup Commune (pseudonym), Phnom Penh, and Bangkok, the authors describe the public health dimensions of maternal mortality risks faced by unmarried Cambodian migrant women due to various unsafe abortion methods employed as birth control methods.