Contribution of psychosocial factors to the association between socioeconomic position and takeaway food consumption

Objective To examine whether psychosocial factors mediate (explain) the association between socioeconomic position and takeaway food consumption. Design A cross-sectional postal survey conducted in 2009. Setting Participants reported their usual consumption of 22 takeaway food items, and these were grouped into a “healthy” and “less healthy” index based on each items' nutritional properties. Principal Components Analysis was used to derive three psychosocial scales that measured beliefs about the relationship between diet and health (α = 0.73), and perceptions about the value (α = 0.79) and pleasure (α = 0.61) of takeaway food. A nutrition knowledge index was also used. Socioeconomic position was measured by highest attained education level. Subjects Randomly selected adults (n = 1,500) aged between 25–64 years in Brisbane, Australia (response rate  =  63.7%, N = 903). Results Compared with those with a bachelor degree or higher, participants with a diploma level of education were more likely to consume “healthy” takeaway food (p = 0.023) whereas the least educated (high school only) were more likely to consume “less healthy” choices (p = 0.002). The least educated were less likely to believe in a relationship between diet and health (p<0.001), and more likely to have lower nutritional knowledge compared with their highly educated counterparts (p<0.001). Education differences in beliefs about the relationship between diet and health partly and significantly mediated the association between education and “healthy” takeaway food consumption. Diet- and health-related beliefs and nutritional knowledge partly and significantly mediated the education differences in “less healthy” takeaway food consumption. Conclusions Interventions that target beliefs about the relationship between diet and health, and nutritional knowledge may reduce socioeconomic differences in takeaway food consumption, particularly for “less healthy” options.

A framework for evaluating the impact of obesity prevention strategies on socioeconomic inequalities in weight

We developed a theoretical framework to organize obesity prevention interventions by their likely impact on the socioeconomic gradient of weight. The degree to which an intervention involves individual agency versus structural change influences socioeconomic inequalities in weight. Agentic interventions, such as standalone social marketing, increase socioeconomic inequalities. Structural interventions, such as food procurement policies and restrictions on unhealthy foods in schools, show equal or greater benefit for lower socioeconomic groups. Many obesity prevention interventions belong to the agento–structural types of interventions, and account for the environment in which health behaviors occur, but they require a level of individual agency for behavioral change, including workplace design to encourage exercise and fiscal regulation of unhealthy foods or beverages. Obesity prevention interventions differ in their effectiveness across socioeconomic groups. Limiting further increases in socioeconomic inequalities in obesity requires implementation of structural interventions. Further empirical evaluation, especially of agento–structural type interventions, remains crucial.

Cycling for transport and recreation: Associations with the socio-economic, natural and built environment

This study examined associations between objective environmental attributes and, separately, transport (TC) and recreational cycling (RC). Environmental attributes were more strongly associated with TC than RC. Distances to areas with the best bicycle infrastructure and urban amenities may be key environmental factors influencing TC but not RC. Government investments in bicycle infrastructure within inner Brisbane appear to have resulted in more TC than in outer areas and to appeal to residents of both the most and least disadvantaged neighbourhoods. Extending this infrastructure to residents living in disadvantaged and advantaged neighbourhoods outside the CBD could expand TC participation.

Social determinants of health and diabetic foot disease

Background Diabetic foot disease (DFD) is the leading cause of hospitalisation and lower extremity amputation (LEA) in people with diabetes. Many studies have established the relationship between DFD and clinical risk factors, such as peripheral neuropathy and peripheral arterial disease. Other studies have identified the relationship between diabetes and non-clinical risk factors termed social determinants of health (SDoH), such as socioeconomic status. However, it appears very few studies have investigated the relationship between DFD and SDoH. This paper aims to review the existing literature investigating the relationship between DFD and the SDoH factors socioeconomic status (SES), race and geographical remoteness (remoteness). Process Electronic databases (MEDLINE, CINAHL, and PubMed) were searched for studies reporting SES, race (including Aboriginal and Torres Strait Islander in Australia) and remoteness and their relationship to DFD and LEA. Exclusion criteria were studies conducted in developing countries and studies published prior to 2000. Findings Forty-eight studies met the inclusion criteria and were reviewed; 10 in Australia. Overall, 28 (58%) studies investigated LEA, 10 (21%) DFD, and 10 (21%) DFD and LEA as the DFD-related outcome. Thirty-six (75%) studies investigated the SDoH risk factor of race, 22 (46%) SES, and 20 (42%) remoteness. SES, race and remoteness were found to be individually associated with LEA and DFD in the majority of studies. Only four studies investigated interactions between SES, race and remoteness and DFD with contrasting findings. All four studies used only LEA as their investigated outcome. No Australian studies investigate the interaction of all three SDoH risk factors on DFD outcomes. Conclusions The SDoH risk factors of SES, race and GR appear to be individually associated with DFD. However, only few studies investigated the interaction of these three major SDoH risk factors and DFD outcomes with contrasting results. There is a clear gap in this area of DFD research and particularly in Australia. Until urgent future research is performed, current practice and policy does not adequately take into consideration the implication of SDoH on DFD.

Competitive fitness in coronaviruses is not correlated with size or number of double-membrane vesicles under reduced-temperature growth conditions

Positive-stranded viruses synthesize their RNA in membrane-bound organelles, but it is not clear how this benefits the virus or the host. For coronaviruses, these organelles take the form of double-membrane vesicles (DMVs) interconnected by a convoluted membrane network. We used electron microscopy to identify murine coronaviruses with mutations in nsp3 and nsp14 that replicated normally while producing only half the normal amount of DMVs. Viruses with mutations in nsp5 and nsp16 produced small DMVs but also replicated normally. Quantitative RT-PCR confirmed that the most strongly affected of these, the nsp3 mutant, produced more viral RNA than wild-type virus. Competitive growth assays were carried out in both continuous and primary cells to better understand the contribution of DMVs to viral fitness. Surprisingly, several viruses that produced fewer or smaller DMVs showed a higher relative fitness compared to wild-type virus, suggesting that larger and more numerous DMVs do not necessarily confer a competitive advantage in primary or continuous cell culture. For the first time, this directly demonstrates that replication and organelle formation may be, at least in part, studied separately during positive-stranded RNA virus infection.

Urban area disadvantage and physical activity: a multilevel study in Melbourne, Australia

Objective: To estimate variation between small areas in the levels of walking, cycling, jogging, and swimming and overall physical activity and the importance of area level socioeconomic disadvantage in predicting physical activity participation.

Methods: All census collector districts (CCDs) in the 20 innermost local government areas in metropolitan Melbourne, Australia, were identified and ranked by the percentage of low income households (<$400/week) living in the CCD. Fifty CCDs were randomly selected from the least, middle, and most disadvantaged septiles of the ranked CCDs and 2349 residents (58.7% participation rate) participated in a cross sectional postal survey about physical activity. Multilevel logistic regression (adjusted for extrabinomial variation) was used to estimate area level variation in walking, cycling, jogging, and swimming and in overall physical activity participation, and the importance of area level socioeconomic disadvantage in predicting physical activity participation.

Results: There were significant variations between CCDs in all activities and in overall physical participation in age and sex adjusted models; however, after adjustment for individual SES (income, occupation, education) and area level socioeconomic disadvantage, significant differences remained only for walking (p = 0.004), cycling (p = 0.003), and swimming (p = 0.024). Living in the most socioeconomically disadvantaged areas was associated with a decreased likelihood of jogging and of having overall physical activity levels that were sufficiently active for health; these effects remained after adjustment for individual socioeconomic status (sufficiently active: OR 0.70, 95% CI 0.55 to 0.90 and jogging: OR = 0.69, 95% CI 0.51 to 0.94).

Conclusion: These research findings support the need to focus on improving local environments to increase physical activity participation.

Abbreviations: SES, socioeconomic status; CCD, census collector district

Weight and place: a multilevel cross-sectional survey of area-level social disadvantage and overweight/obesity in Australia

Objective: To estimate variation between small areas in adult body mass index (BMI), and assess the importance of area level socioeconomic disadvantage in predicting BMI.

Methods: We identified all census collector districts (CCDs) in the 20 innermost Local Government Areas in metropolitan Melbourne, Australia, and ranked them by the percentage of low income households (<$400/week). In all, 50 CCDs were randomly selected from the least, middle and most disadvantaged septiles of the ranked list and 4913 residents (61.4% participation rate) completed one of two surveys. Multilevel linear regression was used to estimate area level variance in BMI and the importance of area level socioeconomic disadvantage in predicting BMI.

Results: There were significant variations in BMI between CCDs for women, even after adjustment for individual and area SES (P=0.012); significant area variation was not found for men. Living in the most versus least disadvantaged areas was associated with an average difference in BMI of 1.08 kg/m² (95% CI: 0.48–1.68 kg/m²) for women, and of 0.93 kg/m² (95% CI: 0.32–1.55 kg/m²) for men. Living in the mid versus least disadvantaged areas were associated with an average difference in BMI of 0.67 kg/m² (95% CI: 0.09–1.26 kg/m²) for women, and 0.43 kg/m² for men (95% CI: -0.16–1.01).

Conclusion: These findings suggest that area disadvantage is an important predictor of adult BMI, and support the need to focus on improving local environments to reduce socioeconomic inequalities in overweight and obesity.

Area variation in recreational cycling in Melbourne : a compositional or contextual effect?

Objective: To examine whether compositional and/or contextual area characteristics are associated with area socioeconomic inequalities and between-area differences in recreational cycling.

Setting: The city of Melbourne, Australia.

Participants: 2349 men and women residing in 50 areas (58.7% response rate).

Main outcome measure: Cycling for recreational purposes (at least once a month vs never).

Design: In a cross-sectional survey participants reported their frequency of recreational cycling. Objective area characteristics were collected for their residential area by environmental audits or calculated with Geographic Information Systems software. Multilevel logistic regression models were performed to examine associations between recreational cycling, area socioeconomic level, compositional characteristics (age, sex, education, occupation) and area characteristics (design, safety, destinations or aesthetics).

Results: After adjustment for compositional characteristics, residents of deprived areas were less likely to cycle for recreation (OR 0.66; 95% CI 0.43 to 1.00), and significant between-area differences in recreational cycling were found (median odds ratio 1.48 (95% credibility interval 1.24 to 1.78). Aesthetic characteristics tended to be worse in deprived areas and were the only group of area characteristics that explained some of the area deprivation differences. Safety characteristics explained the largest proportion of between-area variation in recreational cycling.

Conclusion: Creating supportive environments with respect to safety and aesthetic area characteristics may decrease between-area differences and area deprivation inequalities in recreational cycling, respectively.

A gender for change : the future for women in surveying

Women now make up 50% of the working population in the UK, with similar figures reflected across Europe (Williams et al, 2000). Despite this growth, the number of women entering and working in the surveying profession remains consistently low, estimated at 9% of the total of RICS membership in 1999 (Ellison, 1999).

So what is preventing the surveying profession in mimicking the law and medical professions in increasing the participation of women? Is it the lack of awareness of the profession in Schools, Colleges and Careers Education? Is it a traditional perception of a gender-biased profession? Is it the lack of role models for young women? Or is it plain discrimination? If it is one or more of these, then what action should be taken to address the barriers? The paper describes the results of two studies exploring barriers to female entry to the surveying profession and progress made in the profession by women in the UK. The methodologies included questionnaires and interviews with school leavers and with surveying practitioners, male and female, at varying stages of their career.

The studies undertaken by female surveying students found that barriers exist at different points in surveying - at entry and employment, and that some of those barriers are being addressed by the profession in different ways. At the entry point to surveying there is still a lack of awareness of the profession as a career for girls and women. This can be addressed by greater liaison between schools and surveyors in the profession and by increased information and awareness of career advisers. Within the profession there are still barriers for women surveyors to overcome, including work-life balance issues and traditional attitudes of some male surveyors. There are, however, signs of positive change within a number of surveying firms in the UK. The RICS has been identified as an institution that needs to re-examine its attitudes to gender in a number of aspects.

The paper also outlines the work of a project in the UK (which has developed from a European funded project) that is involved in actively addressing the remaining barriers at all levels. The partnership aims to mainstream good practice in recruitment, teaching and learning and employment. Let's TWIST has recently (November 2001) been successful in gaining funds from EQUAL (funded through European Social Fund) with other partners for a major three year project. The aim of the project is to break down gender desegregation in target sectors of employment, and address cultural and attitudinal barriers that promote discrimination by building on the work already developed. Change is clearly happening, and Let's TWIST is one of a number of active groups in this area who are moving things forward towards mainstreaming which, according to the Equal Opportunities Commission (2001)

The impact of globalisation on building surveying in Europe

This research examined the impact of globalisation on building surveying in Europe. Globalisation has resulted in the emergence of three large trading blocs or a global economy depending on the view one takes. This has impacted on property in two ways, by creating transnational companies who operate in many countries but require branding of their property, and companies who wish to invest in property markets other than their country of origin.

Building Surveyors have professional expertise and knowledge valued in the UK since the 1960 and 1970s but until recently not recognised in Europe, partly due to poor awareness of Building Surveying (BS) expertise, legal constraints, and practises relating to the employment of professionals. This is changing with the establishment of European Surveying associations and the globalisation of the RICS.

The results showed four factors provided the reasons for the globalisation of BS skills. These were that Building Surveyors provided a consistent level of service for their clients. Secondly that English is the language of business. Thirdly, clients perceive Europe as a single trading bloc with a need for technical representation in each investment centre, providing them with a fast, knowledgeable service. Fourthly, clients perceive that UK Building Surveyors know what international, or transnational, investors want.

The finding on the current demand for the BS services in Europe is that though demand is large, few Building Surveyors are located in Europe. Secondly, both investors and occupiers require the services of Building Surveyors, and local companies / individuals are beginning to use their professional services. Finally, there is a diverse range of demand for the many BS skills.

Five key barriers to the practice of BS skills in Europe emerged from the research. Firstly, there was the problem of limited local legal and technical knowledge possessed by outsiders. Secondly, there are legal barriers to practice in some cases. Thirdly, other professionals can, and do, offer the services of the Building Surveyor. Fourthly, there can be cultural differences between ‘values’ and ‘norms’ required in business that constitute barriers. Finally there can be ‘communication’ problems when the Building Surveyor is not located in the country where the service is required.

Why do women like working in building conservation?

There is a perception that Building Conservation as a career is different from the mainstream, and it appears to be more attractive to women - at whatever level - than many other careers in the construction industry. Whilst recruitment and publicity can be targeted, the culture within the construction industry can be a barrier to entry for anyone that is "different." As Clara Greed (1999) discovered in her research "the traits, beliefs and lifestyle peculiar to the construction tribe" can inhibit the entry to the industry of a number of groups outside the traditional pool. The growth of women in the workforce generally (some 50% according to Turrell et al, 2000) is nowhere near being matched within the construction industry as a whole - the Construction Industry Board placed it at around 8.6% in 2000 across all positions. The various UK industry and professional bodies are actively supporting the need to attract women, with the CITB saying they want a 10% year on year increase in participation, the RICS have their own Raising the Ratio working group and the RIBA have carried out research to find out "why women leave architecture."

Of course the whole of the industry is not unfriendly to women - there are a number of us who have been in the industry for many years and recognise it as a fulfilling and exciting career - a number of women work as surveyors working on historic buildings. The initiatives that are working towards change might have something to learn from Building Conservation - while the shortage of skills is just as severe in work with historc buildings - this area of work holds an attraction to women, not found elsewhere. This paper draws on research carried out to explore some of the reasons for this.

The study involved sending a questionnaire to twenty women already working in Building Conservation (the response rate was over 100%) and arranging for questionnaires to be completed by school students (male and female) choosing university courses in one school (60 questionnaires sent out, with 35 returned at a response rate of 58%)

The research showed that the majority women working in Building Conservation did not agree that men heavily dominated their sector of the industry, whereas within other areas of the construction industry men make up approximately 90% of the workforce. The research found that women often perceived the Construction Industry to be 'cut-throat', 'egotistical' and 'financially beneficial', whereas they thought Building Conservation required 'patience', 'care' and 'attention to detail'.

Of the women who took part in the research, 87% were working in Building Conservation because of a personal interest , and the main aspect of that attarction was history and architecture. The study examined attitudes of school students choosing careers and the research shows that when male and female sixth form students were told what Building Conservation was about and what it involved, 43% would consider a career in it and 49% would be interested in talking part in a work experience placement working with historic buildings. The shortage of people working in Building Conservation could be reduced if more people were educated about the profession in a way relevant to their skills and interests. In order to assist this action, the study examined ways to introduce Building Conservation careers to school girls and drew on the initiatives that the university is doing to promote careers in the built environment to schoolgirls.

Building a culture

This study provides a case study of two higher educational institutions and their built environment discipline academic culture, with a specific focus on the impact of culture on the participation of females in the subject area. The two institutions, whilst both delivering built environment programmes, are very different. One is in the UK and is a new university, and the other is in Australia and in the top 200 universities of the world (THES, 2004). Comparative studies have become fashionable as a way of determining policy (Broadfoot, 2001) yet it is still important to acknowledge the character of the national policy within which the culture exists. Culture is a concept used to try and indicate the "climate and practices" developed within an organization to handle people, together with the values of the organization (Schein, 1997, p 3). The academic tribes have been described by Becher and Trowler (2001) in some detail, and they acknowledge the huge range of external forces now acting on academic cultures including a diversification of subject areas and the impact of gender on subject areas. Built environment education has traditionally been a gendered (male dominated) subject area and is making efforts to change (Greed, 1999; Turrell, Wilkinson, Astle and Yeo, 2002). The study will try to identify the cultural attributes that exist in each of the two built environment departments and programmes drawing on the signs and symbols that indicate the culture as well as drawing on staff / student experience. A comparative study will be carried out to determine differences and similarities, and potential lessons to be learned by each institution .

The business skills of graduate surveyors

The research examines the role of lifelong learning and the increasing emphasis on the development of transferable key skills, which formed part of the background to the educational debate emanating from the Royal Institution of Chartered Surveyors “Agenda for Change” vision to elevate the status of the RICS qualification.

Extensive research and consultation by the RICS culminated in a series of initiatives to “reinforce the integrity and expertise of the RICS qualification” (RICS, 2003) including a proposal to introduce a mandatory postgraduate business qualification for newly qualified surveyors. The detailed proposal met with opposition from a range of stakeholders. However there appeared to be significant support for the concept of improving the management skills of graduate surveyors. The controversial aspects appeared to be the delivery methods and the definition of the appropriate content in a ‘one size fits all’ package.

The paper is drawn from the findings of a dissertation that examined by means of questionnaires to the differing stakeholder perspectives of employers, educators and students in one UK location, across a range of surveying professional disciplines. The paper provides an opportunity to explore and debate the difficulties in meeting the needs of a complex and wide ranging profession, whilst illustrating the importance of the vision of the RICS.