Can policy ameliorate socioeconomic inequities in obesity and obesity-related behaviours? A systematic review of the impact of universal policies on adults and children

This systematic review examined the impact of universal policies on socioeconomic inequities in obesity, dietary and physical activity behaviours among adults and children. PRISMA-Equity guidelines were followed. Database searches spanned from 2004 to August 2015. Eligible studies assessed the impact of universal policies on anthropometric, dietary or physical activity-related outcomes in adults or children according to socioeconomic position. Thirty-six studies were included. Policies were classified as agentic, agento-structural or structural, and their impact on inequities was rated as positive, neutral, negative or mixed according to the dominant associations observed. Most policies had neutral impacts on obesity-related inequities regardless of whether they were agentic (60% neutral), agento-structural (68% neutral) or structural (67% neutral). The proportion of positive impacts was similar across policy types (10% agentic, 18% agento-structural and 11% structural), with some differences for negative impacts (30% agentic, 14% agento-structural and 22% structural). The majority of associations remained neutral when stratified by participant population, implementation level and socioeconomic position measures and by anthropometric and behavioural outcomes. Fiscal measures had consistently neutral or positive impacts on inequities. Findings suggest an important role for policy in addressing obesity in an equitable manner and strengthen the case for implementing a broad complement of policies spanning the agency-structure continuum.

"Her lively Looks a sprightly Mind disclose, Quick as her Eyes, and as unfix'd as those." - looking, fashion media, and risk culture

This chapter investigates the phenomenon of fashion from the perspective of ‘the look.’ This is achieved by the wearer (as opposed to the designer) and also forms the basis of fashion media, where it represents the ‘decisive moment’ of photography. The chapter argues that the evolving ‘look’ of fashion can be analysed to identify tensions between novelty and emulation, the unique and the universal, in contemporary consumer culture and status-based social-network markets. It explores the work of fashion photographer Corinne Day and artist Olga Tobreluts to identify the theme of ‘risk culture.’

Year 6 students' idiosyncratic notions of unitising, reunitising and regrouping decimal number places

Having flexible notions of the unit (e.g., 26 ones can be thought of as 2.6 tens, 1 ten 16 ones, 260 tenths, etc.) should be a major focus of elementary mathematics education. However, often these powerful notions are relegated to computations where the major emphasis is on "getting the right answer" thus procedural knowledge rather than conceptual knowledge becomes the primary focus. This paper reports on 22 high-performing students' reunitising processes ascertained from individual interviews on tasks requiring unitising, reunitising and regrouping; errors were categorised to depict particular thinking strategies. The results show that, even for high-performing students, regrouping is a cognitively complex task. This paper analyses this complexity and draws inferences for teaching.

Adjusting building thermostats for environmental gains : understanding the issues

There has been increasing reliance on mechanical heating, ventilation and air-conditioning (HVAC) systems to achieve thermal comfort in office buildings. The use of universal standards for thermal comfort adopted in air-conditioned spaces often results in a large disparity between mean daily external summer temperatures and temperatures experienced indoors. The extensive overuse of air-conditioning in warm climates not only isolates us from the vagaries of the external environment, but is generally dependent on non-renewable energy. A pilot study conducted at the Queensland University of Technology (QUT) involved altering the thermostat set-points to two or three degrees above the normal summer setting in two air-conditioned buildings during the subtropical summer. This paper presents the findings of the research that led to the formulation of the test study. The findings of the test study are printed in the companion paper DES 72: Adjusting Building Thermastats for Environmental Gains – a Pilot Study.

Ethnic differences in the BMI-%BF relationships between young Japanese and Australian-Caucasian males living in Australia using dual-energy X-ray absorptiometry

The Body Mass Index (BMI) has been used worldwide as an indicator of fatness. However, the universal cut-off points by the World Health Organisation (WHO) classification may not be appropriate for every ethnic group when consider the relationship with their actual total body fatness(%BF). The application of population-specific classifications to assess BMI may be more relevant to public health. Ethnic differences in the BMI%BF relationship between 45 Japanese and 42 Australian-Caucasian males were assessed using whole body dual-energy X-ray absorptiometry (DXA) scan and anthropometry using a standard protocol. Japanese males had significantly (p<0.05) greater %BF at given BMI values than Australian males. When this is taken into account the newly proposed Asia-Pacific BMI classification of BMI 23 as overweight and 25 as obese may better assess the level of obesity that is associated increased health risks for this population. To clarify the current findings, further studies that compare the relationships across other Japanese populations are recommended.

Revisiting the conceptualization and measurement of service quality

Since the 1980s, industries and researchers have sought to better understand the quality of services due to the rise in their importance (Brogowicz, Delene and Lyth 1990). More recent developments with online services, coupled with growing recognition of service quality (SQ) as a key contributor to national economies and as an increasingly important competitive differentiator, amplify the need to revisit our understanding of SQ and its measurement. Although ‘SQ’ can be broadly defined as “a global overarching judgment or attitude relating to the overall excellence or superiority of a service” (Parasuraman, Berry and Zeithaml 1988), the term has many interpretations. There has been considerable progress on how to measure SQ perceptions, but little consensus has been achieved on what should be measured. There is agreement that SQ is multi-dimensional, but little agreement as to the nature or content of these dimensions (Brady and Cronin 2001). For example, within the banking sector, there exist multiple SQ models, each consisting of varying dimensions. The existence of multiple conceptions and the lack of a unifying theory bring the credibility of existing conceptions into question, and beg the question of whether it is possible at some higher level to define SQ broadly such that it spans all service types and industries. This research aims to explore the viability of a universal conception of SQ, primarily through a careful re-visitation of the services and SQ literature. The study analyses the strengths and weaknesses of the highly regarded and widely used global SQ model (SERVQUAL) which reflects a single-level approach to SQ measurement. The SERVQUAL model states that customers evaluate SQ (of each service encounter) based on five dimensions namely reliability, assurance, tangibles, empathy and responsibility. SERVQUAL, however, failed to address what needs to be reliable, assured, tangible, empathetic and responsible. This research also addresses a more recent global SQ model from Brady and Cronin (2001); the B&C (2001) model, that has potential to be the successor of SERVQUAL in that it encompasses other global SQ models and addresses the ‘what’ questions that SERVQUAL didn’t. The B&C (2001) model conceives SQ as being multidimensional and multi-level; this hierarchical approach to SQ measurement better reflecting human perceptions. In-line with the initial intention of SERVQUAL, which was developed to be generalizable across industries and service types, this research aims to develop a conceptual understanding of SQ, via literature and reflection, that encompasses the content/nature of factors related to SQ; and addresses the benefits and weaknesses of various SQ measurement approaches (i.e. disconfirmation versus perceptions-only). Such understanding of SQ seeks to transcend industries and service types with the intention of extending our knowledge of SQ and assisting practitioners in understanding and evaluating SQ. The candidate’s research has been conducted within, and seeks to contribute to, the ‘IS-Impact’ research track of the IT Professional Services (ITPS) Research Program at QUT. The vision of the track is “to develop the most widely employed model for benchmarking Information Systems in organizations for the joint benefit of research and practice.” The ‘IS-Impact’ research track has developed an Information Systems (IS) success measurement model, the IS-Impact Model (Gable, Sedera and Chan 2008), which seeks to fulfill the track’s vision. Results of this study will help future researchers in the ‘IS-Impact’ research track address questions such as: • Is SQ an antecedent or consequence of the IS-Impact model or both? • Has SQ already been addressed by existing measures of the IS-Impact model? • Is SQ a separate, new dimension of the IS-Impact model? • Is SQ an alternative conception of the IS? Results from the candidate’s research suggest that SQ dimensions can be classified at a higher level which is encompassed by the B&C (2001) model’s 3 primary dimensions (interaction, physical environment and outcome). The candidate also notes that it might be viable to re-word the ‘physical environment quality’ primary dimension to ‘environment quality’ so as to better encompass both physical and virtual scenarios (E.g: web sites). The candidate does not rule out the global feasibility of the B&C (2001) model’s nine sub-dimensions, however, acknowledges that more work has to be done to better define the sub-dimensions. The candidate observes that the ‘expertise’, ‘design’ and ‘valence’ sub-dimensions are supportive representations of the ‘interaction’, physical environment’ and ‘outcome’ primary dimensions respectively. The latter statement suggests that customers evaluate each primary dimension (or each higher level of SQ classification) namely ‘interaction’, physical environment’ and ‘outcome’ based on the ‘expertise’, ‘design’ and ‘valence’ sub-dimensions respectively. The ability to classify SQ dimensions at a higher level coupled with support for the measures that make up this higher level, leads the candidate to propose the B&C (2001) model as a unifying theory that acts as a starting point to measuring SQ and the SQ of IS. The candidate also notes, in parallel with the continuing validation and generalization of the IS-Impact model, that there is value in alternatively conceptualizing the IS as a ‘service’ and ultimately triangulating measures of IS SQ with the IS-Impact model. These further efforts are beyond the scope of the candidate’s study. Results from the candidate’s research also suggest that both the disconfirmation and perceptions-only approaches have their merits and the choice of approach would depend on the objective(s) of the study. Should the objective(s) be an overall evaluation of SQ, the perceptions-only approached is more appropriate as this approach is more straightforward and reduces administrative overheads in the process. However, should the objective(s) be to identify SQ gaps (shortfalls), the (measured) disconfirmation approach is more appropriate as this approach has the ability to identify areas that need improvement.

A review of the economic consequences of a policy of universal leucodepletion as compared to existing practices

Leucodepletion, the removal of leucocytes from blood products improves the safety of blood transfusion by reducing adverse events associated with the incidental non-therapeutic transfusion of leucocytes. Leucodepletion has been shown to have clinical benefit for immuno-suppressed patients who require transfusion. The selective leucodepletion of blood products by bed side filtration for these patients has been widely practiced. This study investigated the economic consequences in Queensland of moving from a policy of selective leucodepletion to one of universal leucodepletion, that is providing all transfused patients with blood products leucodepleted during the manufacturing process. Using an analytic decision model a cost-effectiveness analysis was conducted. An ICER of $16.3M per life year gained was derived. Sensitivity analysis found this result to be robust to uncertainty in the parameters used in the model. This result argues against moving to a policy of universal leucodepletion. However during the course of the study the policy decision for universal leucodepletion was made and implemented in Queensland in October 2008. This study has concluded that cost-effectiveness is not an influential factor in policy decisions regarding quality and safety initiatives in the Australian blood sector.

Strategies for comparing decimal numbers with the same whole-number part

The strategies employed by 130 Grade 5 Brisbane students in comparing decimal numbers which have the same whole-number part were compared with those identified in similar studies conducted in the USA, France and Israel. Three new strategies were identified. Similar to USA results, the most common comparison errors stemmed from the incorrect whole-number strategy in which length is confused with size. The findings of this present study tend to support Resnick et al.’s (1989) hypothesis that the introduction of decimal-fraction recording before common-fraction recording seems to promote better comparison of decimal numbers.

Construction of multiplicative abstract schema for decimal-number numeration

This paper reports on an intervention study planned to help Year 6 students construct the multiplicative structure underlying decimal-number numeration. Three types of intervention were designed from a numeration model developed from a large study of 173 Year 6 students’ decimal-number knowledge. The study found that students could acquire multiplicative structure as an abstract schema if instruction took account of prior knowledge as informed by the model.

Place value, multiplicativity, reunitizing and effective classroom teaching of decimal numeration

Student understanding of decimal number is poor (e.g., Baturo, 1998; Behr, Harel, Post & Lesh, 1992). This paper reports on a study which set out to determine the cognitive complexities inherent in decimal-number numeration and what teaching experiences need to be provided in order to facilitate an understanding of decimal-number numeration. The study gave rise to a theoretical model which incorporated three levels of knowledge. Interview tasks were developed from the model to probe 45 students’ understanding of these levels, and intervention episodes undertaken to help students construct the baseline knowledge of position and order (Level 1 knowledge) and an understanding of multiplicative structure (Level 3 knowledge). This paper describes the two interventions and reports on the results which suggest that helping students construct appropriate mental models is an efficient and effective teaching strategy.

Towards universal high quality early childhood education

The Australian Government has committed $970 million over 5 years to fund the expansion of preschool education and has established a National Early Childhood Education Partnership Agreement with States and Territories to achieve universal preschool access by 2013. The Partnership Agreement acknowledges the role of State and Territory Government in preschool education, and different approaches to preschool provision. It also recognises differences in current preschool participation rates across states and territories. This paper offers snapshots of a number of different models of preschool provision, spanning traditional sessional approaches to some integrated and innovative approaches within the long day care context. The paper explores the newer long day care model and offers recommendations for the delivery of preschool education within this different context.