Food cost and availability in a rural setting in Australia

Introduction: The burden of chronic diseases is rapidly increasing worldwide. In  Australia rural populations have a greater burden of disease. Chronic diseases are largely preventable with diet as a key risk factor. With respect to diet-related chronic disease, dietary risk may be due to poor food access, namely, poor availability and/or the high cost of healthy food. It is likely that poor food access is an issue in rural areas. Objective: To assess food access in rural south-west (SW) Victoria, Australia.

Methods: A total of 53 supermarkets and grocery stores in 42 towns participated in a survey of food cost and availability in the rural area of SW Victoria. The survey assessed availability and cost of a Healthy Food Access Basket (HFAB) which was designed to meet the nutritional needs of a family of 6 for 2 weeks.

Results: Seventy-two percent of the eligible shops in SW Victoria were surveyed. The study found that the complete HFAB was significantly more likely to be available in a town with a chain-owned store (p<0.00). The complete HFAB was less likely to be available from an independently owned store in a town with only one grocery shop (p<0.004). The average cost of the HFAB across SW Victoria was AU$380.30 ± $25.10 (mean ± SD). There was a mean range in difference of cost of the HFAB of $36.92. In particular, high variability was found in the cost of fruits and vegetables.

Conclusions: Cost and availability of healthy food may be compromised in rural areas. Implications: Improvements in food access in rural areas could reduce the high burden of disease suffered by rural communities.

Age related motivational segmentation of wine consumption in a hospitality setting

The wine industry is a multi-billion product value category worldwide with a significant part being sales through hospitality service providers. Although wine sales add considerably to the profitability of many restaurants, hotels, bars and other hospitality establishments, few studies have been conducted into wine purchasing behaviour within hospitality settings. This study identifies the factors that influence consumers to purchase wine and attempts to demonstrate how the basic demographic characteristic of age is a useful variable for segmentation purposes. The study reveals that there are six dominant factors that influence wine purchasing behaviour and that significant differences in purchase motivation exist between three age segments, 18 to 25 years, 26 to 34 years and 34+years. The results of this research have significant implications for hospitality operators who, with a basic knowledge of the demographic characteristics of their guests, can develop marketing strategies to maximise the sale of wine and wine products

The relationship between patient blood pathology values and patient falls in an acute-care setting : a retrospective analysis

Few studies have investigated the relationship between patient falls and patient blood pathology values, which can reveal objective information about the health and nutritional status of a patient. It could be that some abnormal values are associated with patients that fall. The objectives of the current study were to determine whether blood pathology values were different in patients who fell compared to patients who did not fall, and whether there was a difference in the type and number of currently documented risk factors for falls found for patients who fell compared to patients who did not fall. A retrospective audit of patient incident reports and medical records was conducted in an acute-care hospital for 220 patients who fell and who did not fall. Faller and non-faller patients were matched by casemix type and length of stay. Findings revealed a significant relationship between patients who fell and the variables of age, confusion status and alkaline phosphatase blood values.

Global priority setting for Cochrane systematic reviews of health promotion and public health research

Background: Systematic reviews of health promotion and public health interventions are increasingly being conducted to assist public policy decision making. Many intra-country initiatives have been established to conduct systematic reviews in their relevant public health areas. The Cochrane Collaboration, an international organisation established to conduct and publish systematic reviews of healthcare interventions, is committed to high quality reviews that are regularly updated, published electronically, and meeting the needs of the consumers.

Aims: To identify global priorities for Cochrane systematic reviews of public health topics.

Methods: Systematic reviews of public health interventions were identified and mapped against global health risks. Global health organisations were engaged and nominated policy-urgent titles, evidence based selection criteria were applied to set priorities.

Results: 26 priority systematic review titles were identified, addressing interventions such as community building activities, pre-natal and early infancy psychosocial outcomes, and improving the nutrition status of refugee and displaced populations.

Discussion: The 26 priority titles provide an opportunity for potential reviewers and indeed, the Cochrane Collaboration as a whole, to address the previously unmet needs of global health policy and research agencies.

A clinical nursing leadership model for enhancing continence care for older adults in a subacute inpatient care setting

This article describes the application and evaluation of a clinical nursing leadership model to enhance continence care in an inpatient rehabilitation setting for older adults. Multiple strategies were employed to optimize the uptake and sustainability of 3 practice initiatives: (1)  establishment of an enhanced role for wardbased nurses to provide clinical support to patients and other staff for the management of incontinence, (2) a new method for nursing assessment and management of bowel elimination, and (3) a framework for improved discharge care of patients with incontinence. Evaluation data indicated a high level of acceptance of the role of the ward-based continence resource nurses, improved assessment and management of bowel elimination, and enhanced discharge care for patients with incontinence. These initiatives were sustainable during a 2-year period after their introduction, despite the gradual withdrawal of the clinical leader.

Sex offenders in a risk society : setting limits on freedom

The commendable intention to protect children from risk must be weighed against loss of personal freedom when imposing extended supervision orders under the Serious Sex Offenders Monitoring Act.

Trial application of a model of resource utiliztion, costs, and outcomes for stroke (MORUCOS) to assist priority setting in stroke.

Background and Purpose— Cost-effectiveness data for stroke interventions are limited, and comparisons between studies are confounded by methodological inconsistencies. The aim of this study was to trial the use of the intervention module of the economic model, a Model of Resource Utilization, Costs, and Outcomes for Stroke (MORUCOS) to facilitate evaluation and ranking of the options.

Methods— The approach involves using an economic model together with added secondary considerations. A consistent approach was taken using standard economic evaluation methods. Data from the North East Melbourne Stroke Incidence Study (NEMESIS) were used to model "current practice" (base case), against which 2 interventions were compared. A 2-stage process was used to measure benefit: health gains (expressed in disability-adjusted life years [DALYs]) and filter analysis. Incremental cost-effectiveness ratios (ICERs) were calculated, and probabilistic uncertainty analysis was undertaken.

Results— Aspirin, a low-cost intervention applicable to a large number of stroke patients (9153 first-ever cases), resulted in modest health benefits (946 DALYs saved) and a mean ICER (based on incidence costs) of US $1421 per DALY saved. Although the health gains from recombinant tissue-type plasminogen activator (rtPA) were less (155 DALYs saved), these results were impressive given the small number of persons (256) eligible for treatment. rtPA dominates current practice because it is more effective and cost-saving.

Conclusions— If used to assess interventions across the stroke care continuum, MORUCOS offers enormous capacity to support decision-making in the prioritising of stroke services.

Human right to food security in refugee setting: rhetoric versus reality

Despite recent advances in the area of humanitarian responses and the publication and dissemination of various guidelines with regard to nutritional interventions, there is, however a paucity of studies which have examined the human right to food in complex emergencies. 186 countries including those affected by both human made and natural disasters and countries who are donors of humanitarian relief aid adopted the Rome Declaration on Food Security and World Summit plan of Action reaffirming “ the right to adequate food and the fundamental right of everyone to be free from hunger”. The human right to adequate and nutritious food in refugee settings implies that every refugee has physical and economic access to sufficient food to provide the necessary nutrients for effective physical and physiological functions and achieve well being. There are many grounds for believing that the current humanitarian responses to disasters more often violate than respect the human right to adequate and nutritious food. Using elements of household food security as our working framework this paper focuses on the complex ethical and moral questions raised by the conventional humanitarian assistance framework and in particular the issue of human right to food and household food security in refugee settings.

Guanxi in a sub-national cross-cultural setting

This paper explores whether Chinese relationship building, Guanxi, is effective in crosscultural sub-national relationships. Derived from research into Sino-Australian Sister City Type Relationships and using material gathered through interviews in China and Australia, a modified Institutional Guanxi conceptual model has been developed. Some propositions are developed to link the components of the Guanxi conceptual model. Different methodologies are explored to determine the most effective way to test the hypotheses in a cross-cultural environment, and future research is outlined.

Consumer complaint behaviour and relationship marketing: a research agenda

A void identified within the Relationship Marketing literature is the lack of research on dissatisfactory or problem relationships, so the utilisation of work that has been conducted in the area of Consumer Complaint Behaviour (CCB) is appropriate. Therefore, this paper identifies ways in which the CCB literature may be used to advance knowledge in the field of Relationship Marketing. As the context of this paper is consumer - service provider relationships, an assessment is made of some of the implications of technology-infusion in service encounters, at two levels, namely at the broad relationship marketing level, that is, the likely impact of technology infusion on consumer - service provider relationships, and then more specifically regarding implications for CCB.

Security management: an information systems setting

Information Systems have been used for many years to analyze problems and compare options in a managed environment. The introduction of computer and information security systems into such an environment is a typical example of a situation to which an Information Systems approach can be applied. In this paper, we examine the issues peculiar to implementation of security in a healthcare environment, looking specifically at one such specially designed system, SIM-ETHICS, which takes a participational approach.