Household food expenditure and its contribution to socioeconomic inequalities in purchasing foods consistent with Australian dietary guideline recommendations

Aim: To examine the amount of money spent on food by household income, and to ascertain whether food expenditure mediates the relationship between household income and the purchase of staple foods consistent with Australian dietary guideline recommendations. ----- ----- Methods: In face-to-face interviews (n = 1003, 66.4% response rate), households in Brisbane, Australia were asked about their purchasing choices for a range of staple foods, including grocery items, fruits and vegetables. For each participant, information was obtained about their total weekly household food expenditure, along with their sociodemographic and household characteristics. ----- ----- Results: Household income was significantly associated with food expenditure; participants residing in higher-income households spent more money on food per household member than those from lower-income households. Lower income households were less likely to make food purchasing choices of dietary staples that were consistent with recommendations. However, food expenditure did not attenuate the relationship between household income and the purchase of staple foods consistent with dietary guideline recommendations. ----- ----- Conclusions: The findings suggest that food expenditure may not contribute to income inequalities in purchasing staple foods consistent with dietary guideline recommendations: instead, other material or psychosocial factors not considered in the current study may be more important determinants of these inequalities. Further research should examine whether expenditure on non-staple items and takeaway foods is a larger contributor to socioeconomic inequalities in dietary behavior.

The identification of Malaysian contractor satisfaction dimensions : a strategy for continuous improvement

The unique characteristics of the construction industry - such as the fragmentation of its processes, varied scope of works and diversity of its participants - are contributory factors to poor project performance. Several issues are unresolved due to the lack of a comprehensive technique to measure project outcomes including: inefficient decision making, insufficient communication, uncertain site conditions, a continuously changing environment, inharmonious working relationships, mismatched objectives within the project team and a blame culture. One approach to overcoming these problems appears to be to measure performance by gauging contractor satisfaction (Co-S) levels, but this has not been widely investigated as yet. Additionally, the key Co-S dimensions at the project level are still not fully identified. ----- ----- This paper concerns a study of satisfaction dimensions, primarily by a postal questionnaire survey of construction contractors registered by the Malaysian Construction Industry Development Board (CIDB). Eight satisfaction dimensions are identified that are significantly and substantially relate to these contractors - comprising: project cost performance, schedule performance, product performance, design satisfaction, site safety, project profitability, business performance and relationships between participants. -Each of these dimensions is accorded different priority levels of satisfaction by different contractors. ----- ----- The output of this study will be useful in raising the awareness and understanding of project teams regarding contractors’ needs, mutual objectives and open communication to help to deliver a successful project.

Strategy content analysis for service identification : a case study on government agencies

In a resource constrained business world, strategic choices must be made on process improvement and service delivery. There are calls for more agile forms of enterprises and much effort is being directed at moving organizations from a complex landscape of disparate application systems to that of an integrated and flexible enterprise accessing complex systems landscapes through service oriented architecture (SOA). This paper describes the analysis of strategies to detect supporting business services. These services can then be delivered in a variety of ways: web-services, new application services or outsourced services. The focus of this paper is on strategy analysis to identify those strategies that are common to lines of business and thus can be supported through shared services. A case study of a state government is used to show the analytical method and the detection of shared strategies.

Technology strategy for re-engineering design and construction

Automation technology can provide construction firms with a number of competitive advantages. Technology strategy guides a firm's approach to all technology, including automation. Engineering management educators, researchers, and construction industry professionals need improved understanding of how technology affects results, and how to better target investments to improve competitive performance. A more formal approach to the concept of technology strategy can benefit the construction manager in his efforts to remain competitive in increasingly hostile markets. This paper recommends consideration of five specific dimensions of technology strategy within the overall parameters of market conditions, firm capabilities and goals, and stage of technology evolution. Examples of the application of this framework in the formulation of technology strategy are provided for CAD applications, co-ordinated positioning technology and advanced falsework and formwork mechanisation to support construction field operations. Results from this continuing line of research can assist managers in making complex and difficult decisions regarding reengineering construction processes in using new construction technology and benefit future researchers by providing new tools for analysis. Through managing technology to best suit the existing capabilities of their firm, and addressing the market forces, engineering managers can better face the increasingly competitive environment in which they operate.

Technology strategy and competitive performance in bridge construction

Pragmatic construction professionals, accustomed to intense price competition and focused on the bottom line, have difficulty justifying investments in advanced technology. Researchers and industry professionals need improved tools to analyze how technology affects the performance of the firm. This paper reports the results of research to begin answering the question, “does technology matter?” The researchers developed a set of five dimensions for technology strategy, collected information regarding these dimensions along with four measures of competitive performance in five bridge construction firms, and analyzed the information to identify relationships between technology strategy and competitive performance. Three technology strategy dimensions—competitive positioning, depth of technology strategy, and organizational fit—showed particularly strong correlations with the competitive performance indicators of absolute growth in contract awards and contract award value per technical employee. These findings indicate that technology does matter. The research also provides ways to analyze options for approaching technology and ways to relate technology to competitive performance for use by managers. It also provides a valuable set of research measures for technology strategy.

Analysing the effect of digital technology on channel strategy, power and disintermediation in the home video market : the demise of the video store?

The antecedents of channel power (e.g. El-Ansary and Stern, 1972) and the impact of channel structure ( e.g. Anderson and Narus,1984) on channel dynamics have long been important topics within the channel literature. In addition to the theoretical and methodological contributions, research in these areas has helped channel managers to understand how power is generated and used in coordinating distribution strategies in different contexts. The study presented in this paper builds upon these previous literatures, which are first briefly reviewed below.

Overloading truck traffic study and strategy to minimise it

Overloaded truck traffic is a significant problem on highways around the world. Developing countries in particular, overloaded truck traffic causes large amounts of unexpected expenditure in terms of road maintenance because of premature pavement damage. Overloaded truck traffic is a common phenomenon in developing countries, because of inefficient road management and monitoring systems. According to the available literature, many developing countries are facing the same problem, which is economic loss caused by the existence of overloaded trucks in the traffic stream. This paper summarizes the available literature, news reports, journal articles and traffic research regarding overloaded traffic. It examines the issue of overloading and the strategies and legislation used in developed countries.

Strategy in developing cell based therapy for large bone

Regeneration of osseous defects by tissue-engineering approach provides a novel means of treatment utilizing cell biology, materials science, and molecular biology. The concept of in vitro cultured osteoblasts having an ability to induce new bone formation has been demonstrated in the critical size defects using small animal models. The bone derived cells can be incorporated into bioengineered scaffolds and synthesize bone matrix, which on implantation can induce new bone formation. In search of optimal cell delivery materials, the extracellular matrix as cell carriers for the repair and regeneration of tissues is receiving increased attention. We have investigated extracellular matrix formed by osteoblasts in vitro as a scaffold for osteoblasts transplantation and found a mineralized matrix, formed by human osteoblasts in vitro, can initiate bone formation by activating endogenous mesenchymal cells. To repair the large bone defects, osteogenic or stem cells need to be prefabricated in a large three dimensional scaffold usually made of synthetic biomaterials, which have inadequate interaction with cells and lead to in vivo foreign body reactions. The interstitial extracellular matrix has been applied to modify biomaterials surface and identified vitronectin, which binds the heparin domain and RGD (Arg-Gly-Asp) sequence can modulate cell spreading, migration and matrix formation on biomaterials. We also synthesized a tri-block copolymer, methoxy-terminated poly(ethylene glycol)(MPEG)-polyL-lactide(PLLA)-polylysine(PLL) for human osteoblasts delivery. We identified osteogenic activity can be regulated by the molecular weight and composition of the triblock copolymers. Due to the sequential loss of lineage differentiation potential during the culture of bone marrow stromal cells that hinderers their potential clinical application, we have developed a clonal culture system and established several stem cell clones with fast growing and multi-differentiation properties. Using proteomics and subtractive immunization, several differential proteins have been identified and verified their potential application in stem cell characterization and tissue regeneration

Technology strategy and competitive performance : A study of bridge construction

Doctoral dissertation, Stanford University, California, 1993

Knowledge management strategy for the Building Division, Queensland Department of Public Works

This paper describes the background and methodology developed and employed in undertaking research developing a Knowledge Management Strategy for a key construction focused government agency. This paper reviews this methodology and examines a likely Knowledge Management Strategy. Two central objectives structure this Case Study: 1. Identify categories of important information generated by the Building Division, Queensland Department of Public Works in its service delivery to internal and external stake-holders, and 2. Formulate an appropriate and targeted Knowledge Management Strategy to meet the needs of the Queensland Building Capital Works program. The structure of this paper includes: *Description of the Queensland construction industry setting *Review the relevant literature *Design an appropriate research methodology *Analyse results *Formulate conclusions, contributions and implications of the targeted strategy.

Facilitating learning in a real time strategy computer game

The aim of this project was to implement a just-in-time hints help system into a real time strategy (RTS) computer game that would deliver information to the user at the time that it would be of the most benefit. The goal of this help system is to improve the user’s learning in terms of their rate of learning, retention and avoidance of stagnation. The first stage of this project was implementing a computer game to incorporate four different types of skill that the user must acquire, namely motor, perceptual, declarative knowledge and strategic. Subsequently, the just-in-time hints help system was incorporated into the game to assess the user’s knowledge and deliver hints accordingly. The final stage of the project was to test the effectiveness of this help system by conducting two phases of testing. The goal of this testing was to demonstrate an increase in the user’s assessment of the helpfulness of the system from phase one to phase two. The results of this testing showed that there was no significant difference in the user’s responses in the two phases. However, when the results were analysed with respect to several categories of hints that were identified, it became apparent that patterns in the data were beginning to emerge. The conclusions of the project were that further testing with a larger sample size would be required to provide more reliable results and that factors such as the user’s skill level and different types of goals should be taken into account.

Maintenance strategy optimization using a continuous-state partially observable semi-Markov decision process

Due to the limitation of current condition monitoring technologies, the estimates of asset health states may contain some uncertainties. A maintenance strategy ignoring this uncertainty of asset health state can cause additional costs or downtime. The partially observable Markov decision process (POMDP) is a commonly used approach to derive optimal maintenance strategies when asset health inspections are imperfect. However, existing applications of the POMDP to maintenance decision-making largely adopt the discrete time and state assumptions. The discrete-time assumption requires the health state transitions and maintenance activities only happen at discrete epochs, which cannot model the failure time accurately and is not cost-effective. The discrete health state assumption, on the other hand, may not be elaborate enough to improve the effectiveness of maintenance. To address these limitations, this paper proposes a continuous state partially observable semi-Markov decision process (POSMDP). An algorithm that combines the Monte Carlo-based density projection method and the policy iteration is developed to solve the POSMDP. Different types of maintenance activities (i.e., inspections, replacement, and imperfect maintenance) are considered in this paper. The next maintenance action and the corresponding waiting durations are optimized jointly to minimize the long-run expected cost per unit time and availability. The result of simulation studies shows that the proposed maintenance optimization approach is more cost-effective than maintenance strategies derived by another two approximate methods, when regular inspection intervals are adopted. The simulation study also shows that the maintenance cost can be further reduced by developing maintenance strategies with state-dependent maintenance intervals using the POSMDP. In addition, during the simulation studies the proposed POSMDP shows the ability to adopt a cost-effective strategy structure when multiple types of maintenance activities are involved.

Evaluation of financial incentives as a quality improvement strategy in the public hospital context : clinician attitudes, design variables, and economic costs

In 2008, a three-year pilot ‘pay for performance’ (P4P) program, known as ‘Clinical Practice Improvement Payment’ (CPIP) was introduced into Queensland Health (QHealth). QHealth is a large public health sector provider of acute, community, and public health services in Queensland, Australia. The organisation has recently embarked on a significant reform agenda including a review of existing funding arrangements (Duckett et al., 2008). Partly in response to this reform agenda, a casemix funding model has been implemented to reconnect health care funding with outcomes. CPIP was conceptualised as a performance-based scheme that rewarded quality with financial incentives. This is the first time such a scheme has been implemented into the public health sector in Australia with a focus on rewarding quality, and it is unique in that it has a large state-wide focus and includes 15 Districts. CPIP initially targeted five acute and community clinical areas including Mental Health, Discharge Medication, Emergency Department, Chronic Obstructive Pulmonary Disease, and Stroke. The CPIP scheme was designed around key concepts including the identification of clinical indicators that met the set criteria of: high disease burden, a well defined single diagnostic group or intervention, significant variations in clinical outcomes and/or practices, a good evidence, and clinician control and support (Ward, Daniels, Walker & Duckett, 2007). This evaluative research targeted Phase One of implementation of the CPIP scheme from January 2008 to March 2009. A formative evaluation utilising a mixed methodology and complementarity analysis was undertaken. The research involved three research questions and aimed to determine the knowledge, understanding, and attitudes of clinicians; identify improvements to the design, administration, and monitoring of CPIP; and determine the financial and economic costs of the scheme. Three key studies were undertaken to ascertain responses to the key research questions. Firstly, a survey of clinicians was undertaken to examine levels of knowledge and understanding and their attitudes to the scheme. Secondly, the study sought to apply Statistical Process Control (SPC) to the process indicators to assess if this enhanced the scheme and a third study examined a simple economic cost analysis. The CPIP Survey of clinicians elicited 192 clinician respondents. Over 70% of these respondents were supportive of the continuation of the CPIP scheme. This finding was also supported by the results of a quantitative altitude survey that identified positive attitudes in 6 of the 7 domains-including impact, awareness and understanding and clinical relevance, all being scored positive across the combined respondent group. SPC as a trending tool may play an important role in the early identification of indicator weakness for the CPIP scheme. This evaluative research study supports a previously identified need in the literature for a phased introduction of Pay for Performance (P4P) type programs. It further highlights the value of undertaking a formal risk assessment of clinician, management, and systemic levels of literacy and competency with measurement and monitoring of quality prior to a phased implementation. This phasing can then be guided by a P4P Design Variable Matrix which provides a selection of program design options such as indicator target and payment mechanisms. It became evident that a clear process is required to standardise how clinical indicators evolve over time and direct movement towards more rigorous ‘pay for performance’ targets and the development of an optimal funding model. Use of this matrix will enable the scheme to mature and build the literacy and competency of clinicians and the organisation as implementation progresses. Furthermore, the research identified that CPIP created a spotlight on clinical indicators and incentive payments of over five million from a potential ten million was secured across the five clinical areas in the first 15 months of the scheme. This indicates that quality was rewarded in the new QHealth funding model, and despite issues being identified with the payment mechanism, funding was distributed. The economic model used identified a relative low cost of reporting (under $8,000) as opposed to funds secured of over $300,000 for mental health as an example. Movement to a full cost effectiveness study of CPIP is supported. Overall the introduction of the CPIP scheme into QHealth has been a positive and effective strategy for engaging clinicians in quality and has been the catalyst for the identification and monitoring of valuable clinical process indicators. This research has highlighted that clinicians are supportive of the scheme in general; however, there are some significant risks that include the functioning of the CPIP payment mechanism. Given clinician support for the use of a pay–for-performance methodology in QHealth, the CPIP scheme has the potential to be a powerful addition to a multi-faceted suite of quality improvement initiatives within QHealth.