Role of age, sex, and obesity in the higher prevalence of arthritis among lower socioeconomic groups: a population-based survey

Objective: To compare the prevalence of arthritis among population groups based on demographic, socioeconomic, and body mass index (BMI) characteristics; to investigate the combined influence of these factors on arthritis; and to assess the relationship between self-reported health and psychological distress and arthritis.

Methods: Data from the Victorian Population Health Survey (n = 7,500) were used in the study. Psychological distress was assessed using the Kessler Psychological Distress scale, and self-reported health was assessed by a single item. Multiple logistic regression was used to investigate the combined influence of demographic and socioeconomic factors and BMI on arthritis.

Results: Overall, 23% of Victorian adults (20% men and 26% women) reported having arthritis. The presence of arthritis was associated with high psychological distress (odds ratio [OR] 1.2; 95% confidence interval [95% CI] 1.1-1.4) and poor self-reported health (OR 1.9; 95% CI 1.7-2.1). Increased prevalence of arthritis was found in older age groups, lower education and income groups, and in people who were overweight or obese. Women had higher risk of arthritis, even after adjustment for age, residence, education, occupation, income, and BMI. Age and BMI independently predicted arthritis for men and women. For men, higher risk of arthritis was also associated with lower income.

Conclusion: Arthritis is a highly prevalent condition associated with poor health and high psychological distress. Prevalence of arthritis is disproportionately high among women and individuals from lower socioeconomic backgrounds. As the prevalence of arthritis is predicted to increase, careful consideration of causal factors, and setting priorities for resource allocation for the treatment and prevention of arthritis are required.

Nutritional and functional status indicators in residents of a long-term care facility

In a cross-sectional study, we determined whether results from the Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), and Katz Activities of Daily Living (ADL), were associated with nutritional status and mobility in long-term care residents. One hundred and fifteen study participants (mean [SD] age: 80.2 [10.6]) provided informed consent. Fifty eight percent (n = 66) responded to all three questionnaires: 12 were assessed as malnourished (MNA < 17) and 28 were depressed (GDS ≥ 6). Higher levels of depression were associated with lower serum zinc (n = 71, r = -.356, p = .001) and associated with a slower Timed Up and Go test (TUG, n = 38, r = .301, p = .030). MNA was also associated with serum zinc (n = 44, r = .307, P = .021). Non responders to questionnaires (n = 36) had a lower BMI (mean difference: -2.5 ± 1.0 kg/m², p = .013) and serum 25(OH)D (-8.7 ± 3.8 nmol/l, p = .023) vs. responders. The GDS, in addition to the MNA, is useful in identifying poor nutritional status in residential care. Intervention programs that target depression and poor nutritional status could potentially improve overall quality of life, but it is not clear if depression is leading to poor nutritional status or if poor nutrition is leading to depression.

Neighbourhood socioeconomic inequalities in food access and affordability

This study investigated whether the availability and accessibility of supermarkets and fruit and vegetable stores, and the availability, variety and price of foods within these stores, varied across areas of different levels of socioeconomic disadvantage in Melbourne, Australia. Data on food store locations, and food variety and price within stores were obtained through objective audits of 45 neighbourhoods of varying socioeconomic disadvantage. Geographical accessibility of healthy food stores was mostly better amongst those living in more advantaged neighbourhoods. Availability of healthy foods within stores only slightly favoured those in advantaged neighbourhoods. However food prices favoured those living in disadvantaged areas.

Socioeconomic position and children's physical activity and sedentary behaviors : longitudinal findings from the CLAN study

Background: This study aimed to examine cross-sectional and longitudinal associations between socioeconomic position (SEP) and physical activity and sedentary behaviors amongst children and adolescents.

Methods: Maternal education was reported by parents of 184 5-6 year-old and 358 10-12 year-old children in 2001. In 2001 and 2004, physical activity was assessed by accelerometry. Older children self-reported and parents of younger children proxy-reported physical activity and television (TV) viewing behaviors. Linear regression was used to predict physical activity and sedentary behaviors, and changes in these behaviors, from maternal education.

Results: Among all children, accelerometer-determined and self/parent-reported moderate and vigorous physical activity declined over three years. Girls of higher SEP demonstrated greater decreases in TV viewing behaviours than those of low SEP. In general, no prospective associations were evident between SEP and objectively-assessed physical activity. A small number of prospective associations were noted between SEP and self-reported physical activity, but these were generally weak and inconsistent in direction.

Conclusions: This study did not find strong evidence that maternal education was cross-sectionally or longitudinally predictive of children’s physical activity or sedentary behaviors. Given the well-documented inverse relationship of SEP with physical activity levels in adult samples, findings suggest that such disparities may emerge after adolescence.

Intervening to improve health indicators among Australian farm families

The Sustainable Farm Families project (http://www.sustainablefarmfamilies.org.au/) was a 3-year demonstration and education project designed to influence farmer behavior with respect to family health and well-being among cropping and grazing farmers in Victoria, New South Wales, and South Australia, Australia. The project was conducted by the Western District Health Service, Hamilton, Australia, in partnership with farmers; Farm Management 500 (peer discussion group); the Victorian Farmers Federation; Royal Melbourne Institute of Technology; and Land Connect. During the 3 years of the project, 128 farmers—men (70) and women (58)—were enrolled. The project utilized a combination of small group workshops, individualized health action plans, and health education opportunities to encourage farm safety and health behavior changes and to elicit sustained improvements in the following health indicators: body mass index (BMI), total cholesterol, fasting blood glucose, and blood pressure. Mean changes in these health indicators were analyzed using repeated measures analysis of variance (ANOVA) and McNemar's test compared the proportion of individuals with elevated indicators. Among participants with elevated values at baseline, the following average reductions were observed: BMI 0.44 kg/m2 (p = .0034), total cholesterol 48.7 mg/dl (p < .0001), blood glucose 10.1 mg/dl (p = .0016), systolic blood pressure 12.5 mm Hg (p < .0001), and diastolic blood pressure 5.0 mm Hg (p = .0007). The proportion of participants with elevated total cholesterol at baseline decreased after 24 months (p < .001). Such findings suggest that proactive intervention by farmer associations, rural health services, and government agencies may be an effective vehicle for promoting voluntary farm safety and health behavior change while empowering farm families to achieve measurable reductions in important health risk factors.

Understanding travel behavior using demographic and socioeconomic variables as travel constraints

Samdahl and Jekubovich (1997) view constraints as a subset of reasons for not engaging in a particular behavior. There is limited empirical research on the role of demographic and socioeconomic variables as travel constraints. This study investigates the relationships between a wide range of short and long trip planning and travel behaviors and sociodemographic constraints comprised of age, income and life cycle.

This research uses data generated from a cross-sectional, self-completed survey on travel and tourism which was collected during 2003 and 2004 from 49,105 Australian respondents. This paper utilizes binomial regression to find that age, income and life stage have significant differential and interactive effects on travel behavior. The results show that sociodemographic variables act in different ways to constrain/free different types of travel behavior. Implications are provided for national and state based tourism authorities. There is a need to understand these phenomena. Current research is addressing these issues.

The development of 'soft' strategic indicators for international client satisfaction

Despite the increasing significance of the construction industry as an emerging sector of the Australian economy, there is inadequate research performed on construction design firms in terms of theoretical and empirical foundations. Although past research has identified the barriers and success factors for firm market entry, evidence suggests that to date no research has explicitly explored the sustainability of construction design firms in international markets. SMEs and their approach to firm internationalisation differ significantly from large manufacturing firms and a vast majority of construction design firms operate as SMEs. This paper develops a sustainable business model for construction design SMEs, which rely upon the development of clear Client Following (CF) versus Market Seeking (MS) strategies to support internal firm strategic and operational management. The understanding of these strategies is vital as the application of either will shape the design management approach of firms, which would in turn impact on the sustainability of these firms in foreign markets. Long-term sustainability of firms in international markets relies heavily upon client satisfaction. Client and project team participants’ communication during various design processes has often been problematic and the added difficulty of communicating across international boundaries further compounds the problem of capturing and maintaining client’s requirements. Therefore this paper develops a model for business sustainability of Australian construction design firms working in international markets by exploring factors that affect client satisfaction across international boundaries, through the development of business performance indicators. These include not only the critical financial capital but also other ‘softer’ indicators, namely: social, cultural and intellectual capital. These act as a firm’s measure of success and the acquisition of this type of capital will provide significant advantages to firms’ success, hence sustainability in international markets.

Migrant youth, cultural identity and media representation

The current social climate of heightened intercultural tensions in culturally pluralist societies such as Australia highlights the need to develop a more nuanced understanding of the complex cultural adjustment processes  encountered by migrant youth in developing and articulating a sense of  national belonging, To this end, this chapter examines migrant settlement experiences as a 'process by which individuals and groups ... maintain their cultural identity while actively participating in the larger societal framework' (Karac 2001). Research into these critical aspects of integration and  acculturation examines identity formation as a cultural process of  renegotiating individual and group identity, and focuses on concepts of belonging, recognition and self-respect (Berry '997). While cultural factors are considered critical indicators of successful integration into the host community, insufficient research has been conducted into the particular processes of group and individual identity formation that take place amongst migrant youth. In the case of Australia, this process has been made  particularly difficult for some cultural groups due to the contemporary resurgence of populist and exclusionary discourses of national identity. In such a context, the construction of identity amongst migrant youth is all the more challenging, especially when this process exhibits notions of dual attachment, hybridity and difference. For migrant youth, the engagement with different social institutions such as family, school and wider societal networks often affects the processes of identity 'formation that are inherently  dynamic and 'necessarily multiple and fluid' (Noble & Tabar 2002, pp.I28). Negotiating life in-between cultures, youths from migrant backgrounds experience identity construction as a highly contested territory.

Cultural identity is a central issue for immigrants, regardless of how much time has elapsed since leaving their country of origin. This issue is particularly salient for first- and second-generation1 migrant youth, who negotiate identity space comfortably alongside, in opposition to, or more commonly, somewhere in between, their immigrant parents' conceptions of culture and the receiving culture in which they live. Unlike their native peers,  the children of immigrants arc exposed to intra-ethnic and inter- ethnic   dynamics and experiences in their journey towards cultural identity formation. These experiences are complex and diverse, and are navigated within multi- layered ethnic, racial, familial, gendered, socioeconomic and educational  contexts.

The chapter begins by providing theoretical frameworks for conceptualising  cultural diversity and cultural identity. It then examines how migrant youth  negotiate cultural identity in the public realms of family networks and school  environments and how these translate into key educational and behavioural  outcomes. It will draw on some qualitative snapshots as a way of illustrating  shifting migrant youth attitudes towards society, school and culture.

How should we measure indigenous entrepreneurship? A search for explanatory variables

In Canada and elsewhere around the world Indigenous Peoples are struggling to rebuild their ‘nations’ and improve the socioeconomic circumstances of their people. We are embarking on a program of research in an effort to understand this phenomenon and to inform the process. In this paper we (i) explore the approach to development being adopted by Indigenous people in Canada; (ii) conduct a preliminary literature review; (iii) identify input indicators of entrepreneurship and business development capacity, process measures of development activity and an output indicator of development effectiveness and (v) identify the information available from secondary sources relating to these indicators and the gaps in information that will have to be filled by primary research.

How do we compare? - Applying UK pay for performance indicators to an Australian general practice

BACKGROUND United Kingdom general practitioners receive payment based on their performance in multiple clinical indicators. We set out to apply the same indicators in an Australian general practice to benchmark our performance and to see how much work was required to obtain the data.

METHODS Clinical indicators for the 2008–2009 UK Quality and Outcomes Framework (QOF) cycle were examined and achievement levels measured in a large rural Australian general practice, mainly by computer searching of the clinical database.

RESULTS Outcome measures were obtainable for 79 out of 80 indicators. Manual perusal of computer records was required for 16 indicators. Data collection takes approximately 130 hours. The Australian general practice achieved 66% of available pay for performance points compared to the UK average of 97%.

DISCUSSION United Kingdom QOF clinical data is obtainable relatively easily in a well computerised Australian rural general practice. The exercise identified significant areas in which clinical performance could be improved.

Situational and dispositional indicators of performance : competing models in education

The attainment of high grades on the Victorian Certificate of Education (VCE) is critical to the future study and employment prospects of many Australian adolescents. Thus it is important to understand the factors that contribute to performance in the VCE. The aims of this study were twofold: the main aim was to test competing models of academic performance, subsuming a range of situational and dispositional variables based on a) self-efficacy theory, b) target and purpose goals, c) cognitive skills and self-regulatory strategies, and d) positive psychology. These models were each tested in terms of English performance and mathematics performance as these units contribute proportionally the most to overall VCE scores. In order to study whether pressures peculiar to the VCE impact on performance, the competing models were tested in a sample of Victorian students prior to the VCE (year 10) and then during the VCE (year 11). A preliminary study was conducted in order to develop and test four scales required for use in the major study, using an independent sample of 302 year nine students. The results indicated that these new scales were psychometrically reliable and valid. Three-hundred and seven Australian students participated in the year 10 and 11 study. These students were successively asked to provide their final years 9, 10 and 11 English and mathematics grades at times one, three and five and to complete a series of questionnaires at times two and four. Results of the year 10 study indicated that models based on self-efficacy theory were the best predictors of both English and mathematics performance, with high past grades, high self-efficacy and low anxiety contributing most to performance. While the year 10 self-efficacy models, target goal models, positive psychology models, self-regulatory models and cognitive skill based models were each robust in the sample in year 11, a substantial increase in explained variance was observed from year 10 to year 11 in the purpose goal models. Results indicated that students’ mastery goals and their performance-approach goals became substantially more predictive in the VCE than they were prior to the VCE. This result can be taken to suggest that these students responded in very instrumental ways to the pressures, and importance, of their VCE. An integrated model based on a combination of the variables from the competing models was also tested in the VCE. Results showed that these models were comparable, both in English and mathematics, to the self-efficacy models, but explained less variance than the purpose goal models. Thus in terms of parsimony the integrated models were not preferred. The implications of these results in terms of teaching practices and school counseling practices are discussed. It is recommended that students be encouraged to maintain a positive outlook in relation to their schoolwork and that they be encouraged to set their VCE goals in terms of a combination of self-referenced (mastery) and other-referenced (performance-approach) goals.