Implementing healthy food environment policies in New Zealand: nine years of inaction

Background The INFORMAS [International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action Support] Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. Methods In March–April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 “good practice” policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritized concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. Results In 2020, 60% of the indicators were rated as having “low” or “very little, if any” implementation compared to international benchmarks: less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multisectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. Conclusions There has been little to no progress in the past three terms of government (9 years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many government entities to overcome the existing policy inertia. The increase in food insecurity due to COVID-19 lockdowns may provide the impetus to stimulate action on food polices.

Description and Pilot Evaluation of a Dreamer Ally Training for Higher Education Staff and Faculty

We describe a Dreamer Ally training provided to staff and faculty on a university campus and present results of a pilot evaluation of this training. The Dreamer Ally training was designed to (a) increase university faculty and staff awareness, understanding, and self-efficacy for working with Dreamer students and (b) stimulate action to make the campus more responsive to the challenges and contributions of Dreamer students. For the purpose of this study we define Dreamer students as inclusive of undocumented students, students with the temporary protection of DACA (Deferred Action for Childhood Arrivals), students who qualify for the state’s tuition equity program, and students from mixed legal status families. Study goals were to describe the training, gather pilot data on participant learning goals, post-training satisfaction and self-efficacy for supporting Dreamer students, and generate participant feedback about utility of training components and their plans for subsequent action. Participants completed questionnaires before and after the training. Responses to open-ended questions indicated that most participants attended in order to learn how to better support Dreamer students. Paired samples (pre and post) t-tests indicated significantly higher self-efficacy for supporting Dreamer students at posttest. Participant satisfaction with the training was high and found the information session content and working through different Dreamer student scenarios most useful. Action plans included changing program or unit websites to be more inclusive of Dreamers. Limitations include the absence of a control group. Findings can inform institutional efforts to raise faculty and staff awareness of and responsiveness to the challenges facing Dreamer students.

Influencing factors of knowledge enhancement of corporate universities in China

PurposeCorporate universities are regarded as the knowledge management institution of enterprises, but how to improve knowledge enhancement function has not been investigated. Constructed upon the knowledge-based view, the purpose of this study is to investigate the influencing factors of knowledge enhancement of corporate universities.Design/methodology/approachThis paper takes 34 Chinese corporate universities as samples. The influencing factors and interrelationships are checked through exploratory case study and multi-case analysis. A “stimulate-action” model of influencing factors is built up based on the multi-case analysis. The fuzzy set qualitative comparative analysis is used to examine configurational paths for knowledge enhancement.FindingsThe research finding shows that only a single element of knowledge management does not constitute a necessary condition for knowledge enhancement of corporate university and explored the concurrent synergy effect and linkage matching mode of multiple conditions of knowledge management. Most of the knowledge-enhanced corporate universities are of strengthening the knowledge process, which shows that sorting out the knowledge process is the core of the corporate university.Originality/valueUnlike the existing research, the external teachers and combing of external knowledge processes are the key factors; this paper proposed that the internal teachers and sorting out the knowledge process within the enterprise play a central role in the knowledge enhancement of corporate universities. The path of high-knowledge enhancement and without high-knowledge enhancement is asymmetry. This paper refined and extended the application of the knowledge management framework in explaining multiple conjunctural causations and improves the relevant theories of organizational knowledge management in the Chinese context.

Unlikely disasters

If the threat of disaster—an earthquake, a pandemic, or a nuclear accident—is unlikely or uncertain in time, place, and scale, then prevention may not be seen as better than cure. A potential health emergency becomes more manageable when the cost is commensurate with the hazard and the risk. Tactics to satisfy that criterion are familiar to the insurance industry: spotlight preventable hazards, pool the risks, and share the costs. A hazard—such as COVID-19, Ebola or Zika virus—is perceived to be more dangerous, and more likely to stimulate action, when classified as a public health emergency or a threat to national security. Among the methods for pooling risks and sharing costs are early detection and response systems for multiple pathogens; platform technologies for the development of new diagnostics and vaccines; collaborations through the International Health Regulations (IHR 2005); and shared genomic databases for bacteria and viruses.

Why is Complexity Science valuable for reaching the goals of the UN 2030 Agenda?

The goals and targets included in the 2030 Agenda compiled by the United Nations want to stimulate action in areas of critical importance for humanity and the Earth. These goals and targets regard everyone on Earth from both the health and economic and social perspectives. Reaching these goals means to deal with Complex Systems. Therefore, Complexity Science is undoubtedly valuable. However, it needs to extend its scope and focus on some specific objectives. This article proposes a development of Complexity Science that will bring benefits for achieving the United Nations’ aims. It presents a list of the features shared by all the Complex Systems involved in the 2030 Agenda. It shows the reasons why there are certain limitations in the prediction of Complex Systems’ behaviors. It highlights that such limitations raise ethical issues whenever new technologies interfere with the dynamics of Complex Systems, such as human beings and the environment. Finally, new methodological approaches and promising research lines to face Complexity Challenges included in the 2030 Agenda are put forward.

Implementing Healthy Food Environment Policies in New Zealand: Nine Years of Inaction.

Background: The INFORMAS Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. Methods: In March-April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 ‘good practice’ policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritised concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. Results: In 2020, 60% of the indicators were rated as having ‘low’ or ‘very little if any’ implementation compared to international benchmarks; less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multi-sectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. Conclusions: There has been little to no progress in the past three terms of government (nine years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many Government entities to overcome the existing policy inertia. The increase in food insecurity due to Covid-19 lockdowns may provide the impetus to stimulate action on food polices.

The Cohort Effect Approach to a Friction in Students-Life Beyond Religious and Mental Health for Anxiety Disorder at IAIN Langsa

The article scrutinized a friction stem in students, a false or a real of hope, struggle, and retentive in life when anxiety attacking the consciousness and bridging religious tradition and mental health status. Beyond reality to fantasy, within the inner perceptive, students construct artificial facts in the brain to stimulate action as a course of reactions. The artificial are related to a hope, an expectation, inviting a positive outcome to be believed as an alternative fact to subdue anxiety of fears, which come to overshadow students’ mental status. For inner students’ mental status, there is friction which pressing one to another for their artificial feeling either became the greatest power or worst nightmare affected to daily life and exposure both internally and externally reactions. A cohort effect approaches were applied to observe a longitudinal study for students’ behaviors in contemplating anxiety disorder affect that relied on religious and mental health for an individual sample. Student’s behaviors respect a particular characteristic as the aging process. The approaches aimed at physical features; body shape, decision making, level of aggressiveness, fears, and matting patterns. Thus, students’ frictions are traceable to foresee students’ mental health disorders as an umbrella from a diverse field in clinical psychology.

Improving case detection of tuberculosis in hospitalised Kenyan children—employing the behaviour change wheel to aid intervention design and implementation

Background The true burden of tuberculosis in children remains unknown, but approximately 65% go undetected each year. Guidelines for tuberculosis clinical decision-making are in place in Kenya, and the National Tuberculosis programme conducts several trainings on them yearly. By 2018, there were 183 GeneXpert® machines in Kenyan public hospitals. Despite these efforts, diagnostic tests are underused and there is observed under detection of tuberculosis in children. We describe the process of designing a contextually appropriate, theory-informed intervention to improve case detection of TB in children and implementation guided by the Behaviour Change Wheel. Methods We used an iterative process, going back and forth from quantitative and qualitative empiric data to reviewing literature, and applying the Behaviour Change Wheel guide. The key questions reflected on included (i) what is the problem we are trying to solve; (ii) what behaviours are we trying to change and in what way; (iii) what will it take to bring about desired change; (iv) what types of interventions are likely to bring about desired change; (v) what should be the specific intervention content and how should this be implemented? Results The following behaviour change intervention functions were identified as follows: (i) training: imparting practical skills; (ii) modelling: providing an example for people to aspire/imitate; (iii) persuasion: using communication to induce positive or negative feelings or stimulate action; (iv) environmental restructuring: changing the physical or social context; and (v) education: increasing knowledge or understanding. The process resulted in a multi-faceted intervention package composed of redesigning of child tuberculosis training; careful selection of champions; use of audit and feedback linked to group problem solving; and workflow restructuring with role specification. Conclusion The intervention components were selected for their effectiveness (from literature), affordability, acceptability, and practicability and designed so that TB programme officers and hospital managers can be supported to implement them with relative ease, alongside their daily duties. This work contributes to the field of implementation science by utilising clear definitions and descriptions of underlying mechanisms of interventions that will guide others to do likewise in their settings for similar problems.

Water and national identity in the Netherlands; the history of an idea

According to a popular Dutch theory, water has shaped the Dutch national identity. The Dutch fight against the water would have stimulated perseverance, ingenuity, cooperation and an egalitarian and democratic society. Despite the long water management history of the Netherlands, water became an important part of the self-images of the nation only in the eighteenth Century. In the 1780s the idea that the Dutch had wrung their country from the sea became popular. Initially, this idea was especially popular among the (proto-)liberal opposition, who emphasised the importance of the nation and its achievements. By the end of the nineteenth Century, water had become a national symbol for orthodox Calvinists, Roman Catholics and Socialists too, despite their different views on the nation. Whenever there was fast social change, political turmoil or external threats, as in the late eighteenth Century, the 1930s and 1940s and since the 1990s, the link between water and the Netherlands was used to promote national pride and unity and stimulate action. This link has also been used to promote specific hydraulic works, but it is a topic for further research how widespread and effective this practice was. As this paper is part of a special issue, Water History in the time of COVID-19, it has undergone modified peer review.

Improving case detection of tuberculosis in hospitalised Kenyan children– employing the Behaviour Change Wheel to aid intervention design and implementation

Background The true burden of tuberculosis in children remains unknown, but approximately 65% go undetected each year. Guidelines for tuberculosis clinical decision-making are in place in Kenya and the National Tuberculosis programme conducts several trainings on them yearly. By 2018, there were 183 GeneXpert® machines in Kenyan public hospitals. Despite these efforts, diagnostic tests are underused and there is observed under detection of tuberculosis in children. We describe the process of designing a contextually appropriate, theory-informed intervention to improve case detection of TB in children and implementation guided by the Behaviour Change Wheel.Methods We used an iterative process, going back and forth from quantitative and qualitative empiric data to reviewing literature, and applying the Behaviour Change Wheel guide. The key questions reflected on included: i) what is the problem we are trying to solve; ii) what behaviours are we trying to change and in what way; iii) what will it take to bring about desired change; iv) what types of interventions are likely to bring about desired change; v) what should be the specific intervention content and how should this be implemented?Results The following behaviour change intervention functions were identified: i) training: imparting practical skills; ii) modelling: providing an example for people to aspire/imitate; iii) persuasion: using communication to induce positive or negative feelings or stimulate action; iv) environmental restructuring: changing the physical or social context; and v) education: increasing knowledge or understanding. The process resulted in a multi-faceted intervention package composed of redesigning of child tuberculosis training; careful selection of champions; use of audit and feedback linked to group problem solving; and work flow restructuring with role specification.Conclusion The intervention components were selected for their effectiveness (from literature), affordability, acceptability and practicability and designed so that TB programme officers and hospital managers can be supported to implement them with relative ease, alongside their daily duties. This work contributes to the field of implementation science by utilising clear definitions and descriptions of underlying mechanisms of interventions that will guide others to do likewise in their settings for similar problems.