The North-South gap in overweight and obesity in England

Regional differences in overweight and obesity levels in England have mirrored those of CVD, with higher levels in the North. It is unclear whether the increase in the prevalence of overweight and obesity over the last 15 years has been consistent in different regions of the country. BMI data from each of the health surveys for England conducted between 1993 and 2004 were analysed. Annual grouped estimates of the prevalence of overweight (BMI ≤ 25 kg/m²) and obesity (BMI ≤ 30 kg/m²) for the North and the South of England were produced by appropriately combining regional administrative authorities. Logistic regression analyses were performed to assess the independence of the geographical effect after adjustment for age and social class. The prevalence of both overweight and obesity in women has risen more quickly in the North than in the South between 1993 and 2004, leading to a widening of inequalities. The prevalence of both overweight and obesity in women in the South has remained reasonably stable since 1997. The prevalence rates of both conditions in men have risen in parallel in the North and the South between 1993 and 2004 by approximately 8%. The OR for obesity for young women increased between 1993/98 and 1998/2004 from 1·07 (1·00, 1·14) to 1·21 (1·13, 1·30). Widening geographical inequalities in overweight and obesity rates in women could lead to widening inequalities in cardiovascular and other diseases.

Importance of administrative transparency in the correctional context : knowing the rules

As a class, prisoners are vulnerable to numerous privations while in custody. In particular, prisoners are at a distinct disadvantage in terms of being able to control the central features of their daily lives. The lives of prisoners are circumscribed by numerous rules and regulations and their administration by correctional administrators. It is important that prisoners are aware of the content of the rules that govern their existence and the precise basis upon which power is exercised over them. In a recent freedom of information application in Victoria, a prisoner sought a personal copy of the rules that would govern his life in that particular institution. The prison authorities refused that request. The prisoner then appealed that decision to the Victorian Civil and Administrative Tribunal and was unsuccessful. It is contended that the analysis used in that case was flawed through the misreading of the nature of correctional environment and the fundamental importance of transparency in such a context.

The political economy of maritime industry non-reform in interwar Australia: the establishment of the Maritime Services Board of New South Wales

From the First World War Australian port administration came under criticism from exporters, shipping companies and the Commonwealth government, all of whom argued that port authorities charges imposed an excessive burden on exporters. They sought the replacement of public port authorities by trusts representative of business interests. The campaign for port administration reform also diverted farmers from criticism of shipping freights and to secure their acquiescence in anti-competitive practices in the shipping industry. The formation of the Australian Overseas Transport Association in 1929 was the culmination of this campaign. Elite conservative political support for such anti-competitive practices reflected a belief that competitive capitalism was inherently unstable. The Scullin Labor of 1929-31 government abandoned Labor's earlier hostility to shipping companies to support cartelisation. Conservative state governments, in a more competitive electoral position than their federal counterparts and under greater financial pressure, deflected business calls for port administration reform. Business groups expected the NSW conservative government elected in 1932 to reform port administration towards a representative model, but the Maritime Services Board established in 1935 merely rationalised existing administrative structures. In the 1980s international economic instability legitimated the project of microeconomic reform, particularly in the maritime sector, but in the interwar period a different balance of capital, labour and the state meant that economic isolationism rather than integration was the policy outcome.

Baseline assessment of organizational capacity for health promotion within regional health authorities in Alberta, Canada

This paper provides a baseline profile of organizational capacity for (heart) health promotion in Alberta's regional health authorities (RHAs); and examines differences in perceived organizational health promotion capacity specific to modifiable risk factors across three levels of staff and across capacity levels. Baseline data were collected from a purposive sample of 144 board members, senior/middle managers and service providers from 17 RHAs participating in a five-year time-series repeated survey design assessing RHA capacity for (heart) health promotion. Results indicate low levels of capacity to take health promotion action on the broader determinants of health and risk conditions like poverty and social support. In contrast, capacity for health promotion action specific to physiological and behavioural risk factors is considerably higher. Organizational "will" to do health promotion is noticeably more present than is both infrastructure and leadership. Both position held within an organization as well as overall level of organizational capacity appear to influence perceptions of organizational capacity. Overall, results suggest that organizational "will", while necessary, is inadequate on its own for health promotion implementation to occur, especially in regard to addressing the broader determinants of health. A combination of low infrastructure and limited leadership may help explain a lack of health promotion action.

Procedural justice and affect intensity : understanding reactions to regulatory authorities

Why is it that some people respond in a more negative way to procedural injustice than do others, and why is it that some people go on to defy authority while others in the same situation do not? Personality theorists suggest that the psychological effect of a situation depends on how a person interprets the situation and that such differences in interpretation can vary as a function of individual difference factors. For example, affect intensity—one’s predisposition to react more or less emotionally to an event—is one such individual difference factor that has been shown to influence people’s reactions to events. Cross-sectional survey data collected from (a) 652 tax offenders who have been through a serious law enforcement experience (Study 1), and (b) 672 citizens with recent personal contact with a police officer (Study 2), showed that individual differences in ‘affect intensity’ moderate the effect of procedural justice on both affective reactions and compliance behavior. Specifically, perceptions of procedural justice had a greater effect in reducing anger and reports of non-compliance among those lower in affect intensity than those higher in affect intensity. Both methodological and theoretical explanations are offered to explain the results, including the suggestion that emotions of shame may play a role in the observed interaction.

Scale development of individual and organisation infrastructure for heart health promotion in regional health authorities

Objective : The purpose of this study was to validate measures of individual and organisational infrastructure for health promotion within Alberta's (Canada) 17 Regional Health Authorities (RHAs).

Design : A series of phases were conducted to develop individual and organisational scales to measure health promotion infrastructure. Instruments were designed with focus groups and then pre-tested prior to the validation study.

Setting : In 1993 all hospitals and Public Health Units in the province of Alberta were regionalised into 17 RHAs, with responsibility for public health, community health, and acute and long-term care. While regionalisation may offer more opportunity for community participation, reorganisation of the public health system may have fragmented and diluted resources and skills for heart health promotion in some RHAs. Infrastructure (for example, human and financial resources), amongst other items, is believed to contribute to the capacity to promote health.

Method : All 17 RHAs participated in the study, yielding a total of 144 individuals (that is board members, senior/middle management, and front line staff). These representative employees completed a self- administered questionnaire on individual- and organisational-level infrastructure measures.

Results : Psychometric analyses of survey data provided empirical evidence for the robustness of the measures. Principal component analyses verified the construct validity of the scales, with alpha coefficients ranging from 0.75 to 0.95.

Conclusion : The scales can be used by health professionals and researchers to assess individual- and organisational-level infrastructure, and tailor interventions to increase infrastructure for health promotion in health organisations.

Academic and administrative support for distance learners

The named works discuss the process of completing a doctorate via distance education.

Institutional analysis of strategic choice of micro, small, and medium enterprises : development of a conceptual framework

This paper presents a conceptual framework showing formal and informal institutions and their relationship with the strategic choice of micro, small, and medium enterprises (MSMEs) in a developing country setting. It emphasises how institutions at sub-national level (such as a region or city) influence the strategic orientations of MSMEs as many developing countries in Asia are undergoing decentralisation whereby sub-national government authorities are given more political, economic, fiscal, and administrative powers. Furthermore, it sheds more insights on the environmental (institutional) determinism-organisational (strategic) choice nexus. It offers propositions, questions as well as issues worth pursuing in empirical investigations in the future.

Using clinical trial data and linked administrative health data to reduce the risk of adverse events associated with the uptake of newly released drugs by older Australians : a model process

Background
The study was undertaken to evaluate the contribution of a process which uses clinical trial data plus linked de-identified administrative health data to forecast potential risk of adverse events associated with the use of newly released drugs by older Australian patients.

Methods
The study uses publicly available data from the clinical trials of a newly released drug to ascertain which patient age groups, gender, comorbidities and co-medications were excluded in the trials. It then uses linked de-identified hospital morbidity and medications dispensing data to investigate the comorbidities and co-medications of patients who suffer from the target morbidity of the new drug and who are the likely target population for the drug. The clinical trial information and the linked morbidity and medication data are compared to assess which patient groups could potentially be at risk of an adverse event associated with use of the new drug.

Results
Applying the model in a retrospective real-world scenario identified that the majority of the sample group of Australian patients aged 65 years and over with the target morbidity of the newly released COX-2-selective NSAID rofecoxib also suffered from a major morbidity excluded in the trials of that drug, indicating a substantial potential risk of adverse events amongst those patients. This risk was borne out in post-release morbidity and mortality associated with use of that drug.

Conclusions
Clinical trial data and linked administrative health data can together support a prospective assessment of patient groups who could be at risk of an adverse event if they are prescribed a newly released drug in the context of their age, gender, comorbidities and/or co-medications. Communication of this independent risk information to prescribers has the potential to reduce adverse events in the period after the release of the new drug, which is when the risk is greatest.

Note: The terms 'adverse drug reaction' and 'adverse drug event' have come to be used interchangeably in the current literature. For consistency, the authors have chosen to use the wider term 'adverse drug event' (ADE).

The rural and regional ambulance paramedic : moving beyond emergency response - report to the Council of Ambulance Authorities Inc. March 2006

Serious long-term recruitment and retention problems amongst rural health workers in Australiacontribute to inequitable health service access for rural Australians. In response, new healthcaremodels with flexible workforce roles are emerging including expanded-scope paramedic roles.

This research project was born from the view that expanding ambulance paramedics’ scope ofpractice offers the potential to improve patient care and the general health of the community.New healthcare models with flexible workforce roles are clearly needed in rural Australia andexpanded-scope paramedic roles are valuable innovations.