The Chihuahua sustainability practice: lots of shivering but no real action. Practical sustainability acceptance is low in German and New Zealand firms

Purpose – This paper aims to describe the extent to which corporate organizations in Germany and in New Zealand have included sustainability practices as part of their strategic planning process.

Design/methodology/approach – Current literature is reviewed to make a case for sustainability to be a driver behind corporate decision making and long-term performance. The results of surveys of several hundred firms in both Germany and New Zealand, countries with a publicly stated commitment to sustainability, are reviewed to compare the adoption rates of sustainability practices.

Findings – There is a significant difference between what firms do and what their managers think is important. Managers largely consider sustainability practices an important factor for their future careers, while firms to a large extent do not include sustainability as part of their strategic or operational planning process.

Research limitations/implications – The International Sustainability Acceptance Measurement (ISAM) collects data in several countries through local-language versions of the same online survey tool (www.worldreply.com). The findings in this report are specific only to New Zealand and Germany.

Practical implications – The paper points academics, corporate executives and sustainability fanatics to an alarming inconsistency between what is publicly reported as commitment to sustainability and what is practically achieved.

Originality/value – This paper adds value to the discussion of how sustainability practices have migrated into the operation of firms.

Cost-efficacy of surgically induced weight loss for the management of type 2 diabetes : a randomized controlled trial

OBJECTIVE -- To determine the within-trial cost-efficacy of surgical therapy relative to conventional therapy for achieving remission of recently diagnosed type 2 diabetes in class I and II obese patients.

RESEARCH DESIGN AND METHODS -- Efficacy results were derived from a 2-year randomized controlled trial. A health sector perspective was adopted, and within-trial intervention costs included gastric banding surgery, mitigation of complications, outpatient medical consultations, medical investigations, pathology, weight loss therapies, and medication. Resource use was measured based on data drawn from a trial database and patient medical records and valued based on private hospital costs and government schedules in 2006 Australian dollars (AUD). An incremental cost-effectiveness analysis was undertaken.

RESULTS -- Mean 2-year intervention costs per patient were 13,400 AUD for surgical therapy and 3,400 AUD for conventional therapy, with laparoscopic adjustable gastric band (LAGB) surgery accounting for 85% of the difference. Outpatient medical consultation costs were three times higher for surgical patients, whereas medication costs were 1.5 times higher for conventional patients. The cost differences were primarily in the first 6 months of the trial. Relative to conventional therapy, the incremental cost-effectiveness ratio for surgical therapy was 16,600 AUD per case of diabetes remitted (currency exchange: 1 AUD = 0.74 USD).

CONCLUSIONS -- Surgical therapy appears to be a cost-effective option for managing type 2 diabetes in class I and II obese patients.

Leveraging fan's global football allegiances to build domestic league support

Purpose – It is not uncommon for sports fans to follow multiple sports teams across different sports and even several teams across different leagues of the same sport. Whereas this might be considered a competitive situation, the purpose of this paper is to examine how interest in overseas football (soccer) leagues played a symbiotic role in the successful development of an Australian national soccer league.

Design/methodology/approach – Results of survey data are presented from two clubs in Australia’s newly formed A-League. Three surveys were conducted over a two year period with over 3,700 season ticket holders. Specific attention is paid to fans’ previous interest and exposure to football, which is then related to attitudes and behaviour associated with the new clubs.

Findings – Interest in overseas clubs and leagues is found to be a major antecedent of interest in the Australian league. Those who follow teams in overseas leagues are more likely to be heavy consumers of the new local league than those who follow local leagues or had no prior experience. They also exhibit stronger attitudinal and behavioural loyalty, such as higher attendance and renewal rates of season tickets.

Practical implications – Recognising fan interest in multiple teams/leagues as positive involves a shift in management thinking away from a competitive to a collaborative stance. In this case, rapid adoption of new teams is encouraged by capitalising on strong interest in overseas leagues. This requires careful structuring and branding of the competition that mimicks familiar foreign leagues, while minimising unfavourable comparisons in areas like quality of play.

Originality/value – This study capitalises on the rare opportunity to examine foundation teams in a new national league. The findings highlight the importance and value of taking a ‘‘global’’ perspective to the marketing of sports, and of carefully leveraging the interest in other elite competitions to build interest in new leagues.

Intake of B vitamins in childhood and adult life in relation to psychological distress among women in a British birth cohort

Background : Lower levels of B vitamins (particularly folate, vitamin B12 and vitamin B6) may be associated with psychological distress. Little is known about the impact of childhood nutrition on psychological distress in adult life.

Objective : We investigated whether prospectively measured childhood and adult dietary intakes of thiamin, riboflavin, niacin, folate, vitamin B6 and vitamin B12 were related to the psychological distress of women in mid-age, taking into account socio-economic, behavioural and lifestyle factors.

Design : Prospective data were collected from a cohort of 636 British women followed up since their birth in 1946. Participants completed a 28-item, scaled version of the General Health Questionnaire (GHQ-28) to measure psychological distress at age 53 years. Dietary intakes in childhood (at age four) were determined by 24h recall and in adulthood (at age 36, 43 and 53 years) by a 5d food record.

Results : Low dietary vitamin B12 intake at age 53 was associated with higher psychological distress at that age. Women in the lowest third of vitamin B12 intake in adulthood had a higher GHQ-28 score compared with those in the highest third (percentage change, adjusted regression coefficient, 21 (95% CI 3, 39)). There were no other significant associations between dietary B vitamin intake in childhood or adulthood and psychological distress in the cohort.

Conclusions : Overall, there is evidence that intake of vitamin B12 at age 53 is related to adult psychological distress but there is no evidence for the effects of other adult B vitamin intakes or childhood intakes on psychological distress.

Different sounds, different musics, different teaching : an Australian case study in multicultural teaching and learning

This single case study is part of a wider ongoing research project, begun in 2005, entitled Intercultural attitudes of pre-service music education students from Deakin University and Monash University, Melbourne, Australia. One participant selected from the entire cohort and reinterviewed in 2009 as it was apparent that his experience and expertise outstripped all the others. This paper explores the tensions between authentic pedagogical practice, as understood by the interviewee, in community teaching and in a school. The data generated were analysed using interpretative phenomenological analysis. Three major themes were identified: benefits of community music making, authentic learning, and reality of class music practice. The data demonstrate that authentic socio-cultural understanding is achievable in community music teaching, particularly in the honoring of what individuals bring the sharing of expertise between ensemble players and valuing community arts practice. However, as this is a case study demonstrates, at least in some schools, there is a lack of understanding of how multicultural music could and should be taught. Australian schools should encourage teachers who bring different sounds, different musics and different teaching into the classroom thus resolving to some degree, the potential mismatches between culturally developed learning styles and music teaching methods.

Developing the textual turn : tracking the grammar of research case records

During action research projects a great deal of written material is produced. Some of this is data generated about the project, some about the process of the research and some is reflective writing about the researcher(s). In this article I propose that a deliberate focus on the tracking of texts might be helpful in action research, particularly if the inquiry is working within significant constraints. Working with a range of documents and informed by the work of Dorothy Smith on the texting of ruling relations, I show how a multiagency project based in one school slipped away from its original community development goals into a more 'professional service' model. I also show how the project was able to resist partially the requirement by the funding body to use a rational strategic planning model through the production of taped conversations and meta-analytic papers. Although this is a single case, I contend that this example points to the potential utility of an explicit focus on the textual practices of action research.

Evaluation of a community pharmacy-based intervention for improving patient adherence to antihypertensives: a randomised controlled trial

Background
The majority of patients using antihypertensive medications fail to achieve their recommended target blood pressure. Poor daily adherence with medication regimens and a lack of persistence with medication use are two of the major reasons for failure to reach target blood pressure. There is no single intervention to improve adherence with antihypertensives that is consistently effective. Community pharmacists are in an ideal position to promote adherence to chronic medications. This study aims to test a specific intervention package that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications - Hypertension Adherence Program in Pharmacy (HAPPY).

Methods/Design
The HAPPY trial is a multi-centre prospective randomised controlled trial. Fifty-six pharmacies have been recruited from three Australian states. To identify potential patients, a software application (MedeMine CVD) extracted data from a community pharmacy dispensing software system (FRED Dispense®). The pharmacies have been randomised to either 'Pharmacist Care Group' (PCG) or 'Usual Care Group' (UCG). To check for 'Hawthorne effect' in the UCG, a third group of patients 'Hidden Control Group' (HCG) will be identified in the UCG pharmacies, which will be made known to the pharmacists at the end of six months. Each study group requires 182 patients. Data will be collected at baseline, three and six months in the PCG and at baseline and six months in the UCG. Changes in patient adherence and persistence at the end of six months will be measured using the self-reported Morisky score, the Tool for Adherence Behaviour Screening and medication refill data.

Discussion
To our knowledge, this is the first research testing a comprehensive package of evidence-based interventions that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications. The unique features of the HAPPY trial include the use of MedeMine CVD to identify patients who could potentially benefit from the service, control for the 'Hawthorne effect' in the UCG and the offer of the intervention package at the end of six months to patients in the UCG, a strategy that is expected to improve retention.

Trial Registration
Australian New Zealand Clinical Trial Registry ACTRN12609000705280

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.

Crash landing at INSEAD : initiating a grounded theory of the pedagogical effectiveness of simulation games for teaching aspects of entrepreneurship

A practical teaching difficulty arising in a conducive environment provided opportunity to turn the particular problem into a case study with generic implications. Little research has been conducted on the use or effectiveness of simulation games for teaching entrepreneurship. In the context of established literature critiquing the effectiveness of simulation games as teaching devices in managerial contexts and at a point where problems in using a simulation game as part of entrepreneurship course became evident, the authors designed and executed a single-case research project to generate initial theoretical propositions about the pedagogical effectiveness of simulation games for teaching various concepts and aspects of entrepreneurship. The case analysed the perceived learning environment created when the Sky-High simulation was played by 41 MBA students taking an elective entrepreneurship course at INSEAD. The research design embodied the established methodological principles specified by Yin (1989), for effective case research. Theory building was based upon the grounded-theorizing procedures articulated by Glaser and Strauss (1967). Analysis and synthesis produced a grounded theory, in the form of a normative argument, containing four attribute categories and associated properties required of a simulation game to make it an efficacious teaching device in entrepreneurship contexts. The establishment of this grounded theory has made it both desirable and feasible to contemplate creation of an ISO quality standard for educational simulation games.

Engaging community pharmacists in the primary prevention of cardiovascular disease : protocol for the pharmacist assessment of adherence, risk and treatment in cardiovascular disease (PAART CVD) pilot study

Background: Cardiovascular disease (CVD) is the leading cause of death globally. Community pharmacist intervention studies have demonstrated clinical effectiveness for improving several leading individual CVD risk factors. Primary prevention strategies increasingly emphasise the need for consideration of overall cardiovascular risk and concurrent management of multiple risk factors. It is therefore important to demonstrate the feasibility of multiple risk factor management by community pharmacists to ensure continued currency of their role.
Methods/Design: This study will be a longitudinal pre- and post-test pilot study with a single cohort of up to 100 patients in ten pharmacies. Patients aged 50-74 years with no history of heart disease or diabetes, and taking antihypertensive or lipid-lowering medicines, will be approached for participation. Assessment of cardiovascular risk, medicines use and health behaviours will be undertaken by a research assistant at baseline and following the intervention (6 months). Validated interview scales will be used where available. Baseline data will be used by accredited medicines management pharmacists to generate a report for the treating community pharmacist. This report will highlight individual patients’ overall CVD risk and individual risk factors, as well as identifying modifiable
health behaviours for risk improvement and suggesting treatment and behavioural goals. The treating community pharmacist will use this information to finalise and implement a treatment plan in conjunction with the patient and their doctor. Community pharmacists will facilitate patient improvements in lifestyle, medicines adherence, and medicines management over the course of five counselling sessions with monthly intervals. The primary outcome will be the change to average overall cardiovascular risk, assessed using the Framingham risk equation.
Discussion: This study will assess the feasibility of implementing holistic primary CVD prevention programs into community pharmacy, one of the most accessible health services in most developed countries.

Understanding resilience in same-sex parented families : the work, love, play study

Background: While families headed by same-sex couples have achieved greater public visibility in recent years, there are still many challenges for these families in dealing with legal and community contexts that are not supportive of same-sex relationships. The Work, Love, Play study is a large longitudinal study of same-sex parents. It aims to investigate many facets of family life among this sample and examine how they change over time. The study focuses specifically on two key areas missing from the current literature: factors supporting resilience in same-sex parented families; and health and wellbeing outcomes for same-sex couples who undergo separation, including the negotiation of shared parenting arrangements post-separation. The current paper aims to provide a comprehensive overview of the design and methods of this longitudinal study and discuss its significance.
Methods/Design: The Work, Love, Play study is a mixed design, three wave, longitudinal cohort study of same-sex attracted parents. The sample includes lesbian, gay, bisexual and transgender parents in Australia and New Zealand (including single parents within these categories) caring for any children under the age of 18 years. The study will be conducted over six years from 2008 to 2014. Quantitative data are to be collected via three on-line surveys in 2008, 2010 and 2012 from the cohort of parents recruited in Wave1. Qualitative data will be collected via interviews with purposively selected subsamples in 2012 and 2013. Data collection began in 2008 and 355 respondents to Wave One of the study have agreed to participate in future surveys. Work is currently underway to increase this sample size. The methods and survey instruments are described.
Discussion: This study will make an important contribution to the existing research on same-sex parented families.
Strengths of the study design include the longitudinal method, which will allow understanding of changes over time within internal family relationships and social supports. Further, the mixed method design enables triangulation of qualitative and quantitative data. A broad recruitment strategy has already enabled a large sample size with the inclusion of both gay men and lesbians.

Parenting styles, family structure and adolescent dietary behaviour

Objective To examine associations between parenting styles, family structure and aspects of adolescent dietary behaviour.

Design Cross-sectional study.

Setting Secondary schools in the East Midlands, UK.

Subjects Adolescents aged 12–16 years (n 328, 57 % boys) completed an FFQ assessing their consumption of fruit, vegetables, unhealthy snacks and breakfast. Adolescents provided information on parental and sibling status and completed a seventeen-item instrument measuring the general parenting style dimensions of involvement and strictness, from which four styles were derived: indulgent, neglectful, authoritarian, authoritative.

Results After controlling for adolescent gender and age, analysis of covariance revealed no significant interactions between parenting style and family structure variables for any of the dietary behaviours assessed. Significant main effects for family structure were observed only for breakfast consumption, with adolescents from dual-parent families (P < 0·01) and those with no brothers (P < 0·05) eating breakfast on more days per week than those from single-parent families and those with one or more brother, respectively. Significant main effects for parenting style were observed for all dietary behaviours apart from vegetable consumption. Adolescents who described their parents as authoritative ate more fruit per day, fewer unhealthy snacks per day, and ate breakfast on more days per week than those who described their parents as neglectful.

Conclusions The positive associations between authoritative parenting style and adolescent dietary behaviour transcend family structure. Future research should be food-specific and assess the efficacy of strategies promoting the central attributes of an authoritative parenting style on the dietary behaviours of adolescents from a variety of family structures.

Beyond Simon’s means-ends analysis : natural creativity and the unanswered ‘why’ in the design of intelligent systems for problem-solving

Goal-directed problem solving as originally advocated by Herbert Simon’s means-ends analysis model has primarily shaped the course of design research on artificially intelligent systems for problem-solving. We contend that there is a definite disregard of a key phase within the overall design process that in fact logically precedes the actual problem solving phase. While systems designers have traditionally been obsessed with goal-directed problem solving, the basic determinants of the ultimate desired goal state still remain to be fully understood or categorically defined. We propose a rational framework built on a set of logically interconnected conjectures to specifically recognize this neglected phase in the overall design process of intelligent systems for practical problem-solving applications.

Pharmacy access to the emergency contraceptive pill : a national survey of a random sample of Australian women

Background : The emergency contraceptive pill (ECP) has the potential to assist in reducing unintended pregnancy and abortion rates. Since its rescheduling to pharmacy availability without prescription in Australia in January 2004, there is little information about Australian women's knowledge, attitudes and use of the ECP. The aim of this study was to measure the knowledge about the ECP and sociodemographic patterns of and barriers to use of the ECP.

Study Design : A cross-sectional study, using a computer-assisted telephone interview (CATI) survey conducted with a national random sample of 632 Australian women aged 16–35 years.

Results : Most women had heard of the ECP (95%) and 26% had used it. The majority of women agreed with pharmacy availability of the ECP (72%); however, only 48% were aware that it was available from pharmacies without a prescription. About a third (32%) believed the ECP to be an abortion pill. The most common reason for not using the ECP was that women did not think they were at risk of getting pregnant (57%). Logistic regression showed that women aged 20–29 years (OR 2.58; CI: 1.29–5.19) and 30–35 years (OR 3.16; CI: 1.47–6.80) were more likely to have used the ECP than those aged 16–19 years. Women with poor knowledge of the ECP were significantly less likely to have used it than those with very good knowledge (OR 0.28; CI: 0.09–0.77). Those in a de facto relationship (OR 2.21; CI: 1.27–3.85), in a relationship but not living with the partner (OR 2.46; 95% CI 1.31–4.63) or single women (OR 2.40; CI: 1.33–4.34) were more likely to have used the ECP than married women.

Conclusions : Women in Australia have a high level of awareness of the ECP, but more information and education about how to use it and where to obtain it are still needed.

Efficacy of a referral and physical activity program for survivors of prostate cancer [ENGAGE] : rationale and design for a cluster randomised controlled trial

Background: Despite evidence that physical activity improves the health and well-being of prostate cancer survivors, many men do not engage in sufficient levels of activity. The primary aim of this study (ENGAGE) is to determine the efficacy of a referral and physical activity program among survivors of prostate cancer, in terms of increasing participation in physical activity. Secondary aims are to determine the effects of the physical activity program on psychological well-being, quality of life and objective physical functioning. The influence of individual and environmental mediators on participation in physical activity will also be determined.
Methods/Design: This study is a cluster randomised controlled trial. Clinicians of prostate cancer survivors will be randomised into either the intervention or control condition. Clinicians in the intervention condition will refer eligible patients (n = 110) to participate in an exercise program, comprising 12 weeks of supervised exercise sessions and unsupervised physical activity. Clinicians allocated to the control condition will provide usual care to eligible patients (n = 110), which does not involve the recommendation of the physical activity program. Participants will be assessed at baseline, 12 weeks, 6 months, and 12 months on physical activity, quality of life, anxiety, depression, self-efficacy, outcome expectations, goals, and socio-structural factors.
Discussion: The findings of this study have implications for clinicians and patients with different cancer types or other chronic health conditions. It will contribute to our understanding on the potential impact of clinicians promoting physical activity to patients and the long term health benefits of participating in physical activity programs.