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Aim: The full blood count (FBC) is commonly measured as part of a partial septic work‐up in asymptomatic infants at increased risk of early‐onset neonatal sepsis (EOS). To determine the impact of FBC parameters on infants' subsequent management a retrospective cross‐sectional study was performed. Methods: Infants, born at ≥34 weeks gestation, asymptomatic at birth, undergoing a partial septic work‐up and receiving prophylactic antibiotics due to increased risk of EOS in a single centre over a 2‐year period, were included. The primary outcome measure was frequency of FBC result impacting on duration of antibiotic therapy. Secondary outcome measures included frequency of FBC parameters outside of the reference range and incidental diagnoses. Results: In total, 16 726 live‐born infants were delivered during the study period. A total of 802 (4.8%) were included. Thirteen infants (1.6%) received a prolonged course of antibiotics due to suspicion for EOS. Two of these infants had elevated white cell counts. All had normal neutrophil counts. In no case did the FBC result influence the decision to prolong the antibiotic course. Conclusion: In a cohort of 802 infants, asymptomatic at birth and at increased risk of EOS, the FBC result did not impact on the decision to prolong the course of antibiotics for suspicion of EOS. [ABSTRACT FROM AUTHOR]

• This is the largest published European cohort to date of children with on Toddler's Fractures (TF) managed without immobilisation. • Those managed without immobilisation had similar ED representation rates as those managed with immobilisation. • This study provides baseline data to test the feasibility of supporting a trial of minimal or no immobilisation as a treatment for TF. A Toddler's Fracture (TF) is classically an isolated, nondisplaced, distal-third diaphyseal tibial spiral fracture in younger children. A TF is stable and has a low risk of complication. There is lack of uniformity as to the optimal treatment for TF. Immobilisation with full above knee casting, below knee casting, splinting, controlled ankle motion boots and no immobilisation are all strategies currently in use. There is limited data from European centres regarding those treated without immobilisation. A retrospective review of electronic medical and radiology records was performed to identify all children presenting to a multisite department of paediatric emergency medicine in Ireland from January to December 2022. Those with radiologically confirmed TF or a presumptive diagnosis of TF were included. Data retrieved for each child included initial treatment and the number of and reason for ED reattendances relating to the injury in the 6-month period following the injury. 166 children were identified, 96 with radiologically confirmed TF and 70 with presumptive diagnosis TF. Girls accounted for 47 % of presentations. Fall from a standing height (33 %) was the most common mechanism. 13 % (22/166) children were managed without immobilisation. Those with radiologically confirmed fracture (91/96) were significantly more likely to be immobilised than those with a presumptive diagnosis (53/70) (p = 0.001). In total 28 patients (17 % of total) represented to the ED within 6 months. The representation rate in those immobilised was 17 %, while in those not immobilised was 13 % (p = 0.66). In this cohort, those with no radiological evidence of fracture are more likely to be managed without immobilisation. There was no significant difference in PED representations between those immobilised and not immobilised. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to investigate the food acculturation experiences of Iranian mothers who have migrated to Australia. Methods: The study used qualitative methodology to interview seven mothers with children aged 5 to 15 years, who: carried primary responsibility for family food provisioning; arrived in Australia within the last 5 years; and spoke reasonably fluent English. Results: Seven mothers were interviewed, and the findings revealed three broad themes: (a) adjusting to foods/foodways in Australia (b) sociocultural identity and (c) children and intergenerational conflict. The study highlighted psychosocial and economic stresses associated with food acculturation for this immigrant group. The impact of food acculturation on immigrant health is intricately linked to the complex balance between maintaining traditional cultural identity and practices, while at the same time adapting to the food culture and practices of the new home. Conclusions: Dietitians and healthcare professionals working with such immigrant groups need to consider food acculturation stress as a factor contributing to the health risks of new immigrants. [ABSTRACT FROM AUTHOR]

Objective: To explore how individuals with a laryngectomy (IWL) from diverse backgrounds make meaning and adjust to the physical and functional changes from a total laryngectomy. To examine the extent primary supporters (PS) and health professionals (HP) are able to support IWL with the psychosocial and existential challenges rendered by a surgery that significantly impacts a person's talking, breathing, swallowing, and appearance.Methods: A constructivist grounded theory approach and symbolic interactionism were used to guide data collection and analysis. Semi-structured interviewing occurred.Results: Twenty-eight participants (12 IWL, 9 PS, and 7 HP) were interviewed. The findings suggest that IWL experience significant change to their self-identity and there is evidence of a range of passive and active reframing patterns (destabilised, resigned, resolute, and transformed). The loss of self-expression included changes to communicative participation, personal style, food preferences, and social roles. Short and longer-term supports appear to influence outcomes but are often ill-equipped to manage the psychosocial needs of IWL.Conclusions: Loss of self-expression after total laryngectomy influences self-identity and adjustment. How individuals reframe their identity appears to be tied with how they view their disabilities and disfigurement. These perceptions also appear to be influenced by the reactions of others and the support available. Further resourcing, education, and training are needed so that PS and HP can provide holistic care. [ABSTRACT FROM AUTHOR]

This study aims to report and critically analyze the responses of governance actors to a set of consumers' concerns relating to food labeling, and by doing so describe how these actors construct both consumer perspectives and the food policy environment in which they work. Fifteen food‐labeling governance actors in Australia and New Zealand were asked to view an online presentation of the findings from a previous study exploring consumer perspectives on food labeling and trust before completing a one‐hour, in‐depth, semi‐structured interview. Colebatch's social constructionist perspective on policy was adopted in the analysis. Participants used their own constructions of Australian food policy, the role of labeling and consumer trust as a means to minimize the consumer concerns. Inadequate critical engagement with the moral dimension of consumer concerns is a core driver of the inertia demonstrated in the Australian government's approach to addressing consumer concerns regarding food matters. [ABSTRACT FROM AUTHOR]

The purpose of this article is to map the data currently available on the subject of eating practices and food environments in small (i.e. one- and two-person) households. Specifically, the enquiry is focused on commensality; the act of eating together. Research dates from the late 1980s, however, there are few recent publications on this subject. Searching Ovid MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, ProQuest and Google Scholar, 2949 papers were found, but only 457 discussed any element of the research questions. These were further distilled to a count of 117, by abstract reading to 53 at which point, quality, location and study focus eliminated a further 34 articles leaving 19 articles. After full reading, it was clear that only seven of these focused on the research question in detail and these are marked as four-star articles by bold text. The 19 articles are analysed for quality and their aspects of relevance to the central research question is discussed. [ABSTRACT FROM AUTHOR]

In the face of the ‘obesity epidemic’ public health has largely failed to engage with the human pleasures that surround eating. Pleasures are often linked to vulnerabilities and frailties that are part of being human. We argue in this paper that leaving human vulnerabilities and the pleasures that haunt them under-acknowledged and under-examined within public health contributes to the problems that public health tries to solve. While in some quarters debates revolve around the best ways of encouraging people to become responsible for and modify their own behaviour, the well-documented centuries of struggle with managing human vulnerabilities and pleasures helps to explain why this is no easy task. The mantra of restraint, reason, and rationality is very limited in the face of the importance of some pleasures, even small ones, in human lives. In unequal societies, people have unequal access to pleasures. People are presented with a landscape of temptation, encouraged to consume, and then unequally admonished for indulging according to their means. Understanding and democratising pleasures will involve public health grappling with pleasures, and all those concerned with health inequity asking hard questions about ethics, morality, and intervention. [ABSTRACT FROM AUTHOR]

General consumer knowledge of and engagement with the production of food has declined resulting in increasing consumer uncertainty about, and sensitivity to, food risks. Emphasis is therefore placed on providing information for consumers to reduce information asymmetry regarding food risks, particularly through food labelling. This study examines the role of food labelling in influencing consumer perceptions of food risks. In-depth, 1-h interviews were conducted with 24 Australian consumers. Participants were recruited based on an a priori defined food safety risk scale, and to achieve a diversity of demographic characteristics. The methodological approach used, adaptive theory, was chosen to enable a constant interweaving of theoretical understandings and empirical data throughout the study. Participants discussed perceiving both traditional (food spoilage/microbial contamination) and modern (social issues, pesticide and 'chemical' contamination) risks as present in the food system. Food labelling was a symbol of the food system having managed traditional risks, and a tool for consumers to personally manage perceived modern risks. However, labelling also raised awareness of modern risks not previously considered. The consumer framing of risk presented demonstrates the need for more meaningful consumer engagement in policy decision making to ensure risk communication and management meet public expectations. This research innovatively identifies food labelling as both a symbol of, and a tool for, the management of perceived risks for consumers. Therefore it is imperative that food system actors ensure the authenticity and trustworthiness of all aspects of food labelling, not only those related to food safety. [ABSTRACT FROM AUTHOR]

Aim Trust in the food supply is important when making food choices. However for non- English speakers in an English-speaking country, food choice may be problematic. Specifically, familiar foods may be limited and food safety information is often only communicated in English. This study aimed to identify factors that determine the nature and dimensions of consumer mis/trust in food in selected non- English-speaking populations. Methods Semistructured, in-depth interviews with 17 non- English-speaking participants. Results Qualitative analysis revealed that participants felt that they had no choice but to trust a food system that they did not understand well. However some participants undertook activities to mitigate risk and bolster their trust in the foods they bought and prepared. Conclusions This study highlights a gap in culturally appropriate information for non-English speakers which can affect trust in the food supply. [ABSTRACT FROM AUTHOR]

Background Nutrition education for cardiovascular disease (CVD) management is not effective for all population groups. There is little understanding of the factors that hinder patients from adhering to dietary recommendations. Methods 37 interviews were conducted with people living with CVD in Adelaide, Australia. Recruitment occurred via General Practitioner (GP) clinics and hospital cardiac rehabilitation programs. Participants were either receiving preventive treatment or active treatment for established CVD. Results The volume and contradictory nature of dietary information were the most prominent barriers to making changes identified in interviews, especially by order participants. Conclusion Patients will seek out, or come into contact with information which contradicts advice from their GPs. The volume of information may lead them to resort to old and familiar habits. GPs play a valuable role in highlighting key take-home messages and reliable external sources of information. The findings have implications for GP practice given that lifestyle changes are a cost- and clinically-effective means of managing CVD. [ABSTRACT FROM AUTHOR]

In the past decades, public health has increasingly addressed what has been called the children's obesity 'epidemic', most notably through large-scale initiatives promoting physical activity. Through a discourse analysis the current paper critically examines such efforts in Canadian and Australian public health. Public health websites in Canada and Australia were examined for information concerning children's health, physical activity and obesity and explored for how these issues were represented in the discourse. Bacchi's (2009) 'What's the problem represented to be?' approach to discourse analysis guided our interrogation of the taken-for-granted assumptions underlying Canadian and Australian public health discourse, the ideological and political influences involved in its construction, and the knowledge base upon which it rests. The article calls for critical reflection on how children's physical and leisure activities are being advanced. [ABSTRACT FROM AUTHOR]

Background: The importance of consumer trust in the food supply has previously been identified, and dimensions of consumer trust in food-who they trust and the type of trust that they exhibit-has been explored. However, there is a lack of research about the mechanisms through which consumer trust in the food supply is developed, maintained, broken and repaired. This study seeks to address this gap by exploring if, and how, consumer trust in the food supply is considered by the media, food industry and governments when responding to food scares. The aim of the research is to develop models of trust building that can be implemented following food scares. Methods: Semi-structured interviews will be undertaken with media, public relations officials and policy makers in Australia, New Zealand and the United Kingdom. Participants will be recruited through purposive sampling and will be asked to discuss a hypothetical case study outlining a food incident, and any experiences of specific food scares. Models of trust development, maintenance and repair will be developed from interview data. Comment on these models will be sought from experts in food-related organizations through a Delphi study, where participants will be asked to consider the usefulness of the models. Participants' comments will be used to revise the models until consensus is reached on the suitability and usability of the models. Discussion: This study will contribute to the literature about systems-based trust, and explore trust as a social and regulatory process. The protocol and results will be of interest and use to the food industry, food regulators, consumer advocate groups, media seeking to report food-related issues and policy makers concerned with public health and consumer health and well-being. This research represents an important contribution to the translation of the theoretical conceptualizations of trust into practical use in the context of food. [ABSTRACT FROM AUTHOR]

Food security is an evolving concept with various definitions and associated meanings. The way food security is understood by policy-makers impacts on how it gets addressed in public policy. This research uses an interpretive approach to uncover how food security is represented by stakeholders. Semi-structured interviews were conducted with 24 stakeholders in South Australia between June and September 2010. The findings reveal four dominant representations for food security that locate responsibility for the issue across different stakeholders, namely individuals, governments, communities and private enterprise. These representations hold different underlying assumptions about the role of government in addressing the issue; the neo-liberal perspective supports a reduced role for government whereas the social determinants of health perspective calls for greater government intervention. Food security activists may need a greater awareness of how they represent the issue in order to change public policy action in this area. The approach taken in this research is relevant to other public policy problems and contexts. [ABSTRACT FROM AUTHOR]

Abstract: A growing gap between the production and consumption of food has led to a decline in consumer trust in food, and a desire for increased regulation of food. The aim of this study was to investigate the nature of consumer trust in food production and regulation in the wake of shifts in food technology, globalisation and production. Semi-structured interviews (n =47) were conducted in 2009 with participants living in rural and metropolitan South Australia. Rural participants were more trusting of food production because of their direct experience with producing food than their metropolitan counterparts. Consumers’ embeddedness in food production impacts their trust in food. Increasing local food production and consumption may increase consumer trust in food, and decrease consumer dependence on government regulation. [Copyright &y& Elsevier]

Objective: To profile adults who eat less than the recommended servings of fruit and vegetables per day.Design: Australia-wide population telephone survey on a random sample of the Australian population, with results analysed by univariate and multivariate models.Setting: Australia.Subjects: One thousand one hundred and eight interviews, respondents' (49·3 % males) mean age was 45·12 (sd 17·63) years.Results: Overall 54·8 % and 10·7 % were eating the recommended number of servings of fruit and vegetables. Variables included in the multivariate model indicating low fruit consumption included gender, age, employment, education and those who were less likely to consider the safety and quality of food as important. In regard to low vegetable consumption, people who were more likely to do the food shopping only 'some of the time' and have a high level of trust in groups of people such as immediate family, neighbours, doctors and different levels of government were included in the final model. They were also less likely to neither consider the safety and quality of food as important nor trust organisations/institutions such as the press, television and politicians. In the final model depicting both low fruit and low vegetable servings, sex, age and a low level of importance with regard to safety and quality of food were included.Conclusion: To increase fruit and vegetable consumption, research into a broad range of determinants associated with behaviours should be coupled with a deeper understanding of the process associated with changing behaviours. While levels of trust are related to behaviour change, knowledge and attitudes about aspects associated with safety and quality of food are also of importance. [ABSTRACT FROM AUTHOR]

Objective: To profile adults who eat less than the recommended servings of fruit and vegetables per day. Design: Australia-wide population telephone survey on a random sample of the Australian population, with results analysed by univariate and multivariate models. Setting: Australia. Subjects: One thousand one hundred and eight interviews, respondents' (49·3% males) mean age was 45·12 (SD 17·63) years. Results: Overall 54·8% and 10·7% were eating the recommended number of servings of fruit and vegetables. Variables included in the multivariate model indicating low fruit consumption included gender, age, employment, education and those who were less likely to consider the safety and quality of food as important. In regard to low vegetable consumption, people who were more likely to do the food shopping only 'some of the time' and have a high level of trust in groups of people such as immediate family, neighbours, doctors and different levels of government were included in the final model. They were also less likely to neither consider the safety and quality of food as important nor trust organisations/institutions such as the press, television and politicians. In the final model depicting both low fruit and low vegetable servings, sex, age and a low level of importance with regard to safety and quality of food were included. Conclusion: To increase fruit and vegetable consumption, research into a broad range of determinants associated with behaviours should be coupled with a deeper understanding of the process associated with changing behaviours. While levels of trust are related to behaviour change, knowledge and attitudes about aspects associated with safety and quality of food are also of importance. [ABSTRACT FROM AUTHOR]

ObjectiveThe present study aimed to define the complexity of the relationships between the family environment, health behaviours and obesity. A conceptual model that quantifies the relationships and interactions between parent factors, family environment, and certain aspects of children's behaviour and weight status is presented.DesignExploratory structural equation modelling was used to quantitatively model the relationships between parent, child and family environmental factors.SettingAdelaide, South Australia.SubjectsFamilies (n 157) with children aged 5–10 years completed self-reported questionnaires, providing data on parents’ knowledge, diet quality and activity habits; child feeding and general parenting styles; and the food and physical activity environments. Outcome variables included children's fruit and vegetable intake, activity and sedentary habits and weight status.ResultsThe proposed model was an acceptable fit (normed fit index = 0·457; comparative fit index = 0·746; root-mean-squared error associated = 0·044). Parents’ BMI (β = 0·32) and nutrition and physical activity knowledge (β = 0·17) had the strongest direct associations with children's BMI Z-score. Parents’ dietary intake and energy expenditure behaviours were indirectly associated with children's behaviour through the creation of the home environment. The physical activity and food environments were associated with children's sedentary (β = −0·44) and activity habits (β = 0·29), and fruit and vegetable intake (β = 0·47), respectively.ConclusionsA conceptual model that quantifies the complex network of family environment factors influencing children's behaviour and weight status is presented. The model provides a basis for future research on larger representative samples with a view to guiding obesity prevention interventions. [ABSTRACT FROM PUBLISHER]

To investigate the cost, affordability, availability and quality of a healthy food basket in high and low household income areas of Adelaide, and to investigate food promotion in supermarkets. A cross-sectional survey was undertaken in May 2009 with a sample of 61 supermarkets, 27 greengrocers and 34 butchers in metropolitan Adelaide. Samples were selected based on household income for extreme tertiles across Adelaide. Low-income families were significantly worse off in comparison with high-income families ( P < 0.05) regarding affordability of the healthy food basket. The data analysis demonstrated that families on welfare payments and low incomes would need to spend 28-34% of their income in order to be able to afford a healthy food basket. However, there was no significant difference in the cost, availability, and quality of the healthy food basket and food promotions between high and low household income areas. The present study examined the cost, affordability, availability and quality of the healthy food basket, as well as an assessment of food promotions in supermarkets, finding no difference between high and low household income areas. The study provides valuable information to assist in a deeper understanding of food security in Adelaide. It is recommended that a longitudinal study would assist in establishing a reliable healthy food basket monitoring system that could lead to more robust policy outcomes. [ABSTRACT FROM AUTHOR]

Discourses on drug use and public health show a relative neglect of the study of pleasure. We argue that work on the social, cultural and historical specificity of bodies and the emotions can be usefully drawn upon to study the pleasures of drug use. This article reflects upon the nature of pleasure and its under-representation in public health approaches to drug use and methodologies. It considers four varieties of drug pleasures: carnal pleasure, disciplined pleasure, ascetic pleasure and ecstatic pleasure drawing upon historical work on drugs and related areas. Some observations are made on the pre-eminence of certain drug pleasures today and some tensions and contradictions, which reflect broader contradictions in social values. [ABSTRACT FROM AUTHOR]

The article introduces reports published within the issue including one on risks and perceptions of food safety in Australia, another on childhood obesity and parental responsibility, and one on the individualization of public health and food policy in Japan.

Food scares have diminished trust in public institutions to guarantee food safety. Food governance after the food scare era is concerned with institutional independence and transparency leading to a hybrid of public and private sector management and to mechanisms for consumer involvement in food governance. This paper explores Australian consumers' perceptions of who is, and should be responsible for food safety. Forty-seven participants were interviewed as part of a larger study on trust in the food system. Participants associate food governance with government, industry, and the individual. While few participants can name the national food regulator, there is a strong belief that the government is responsible for regulating the quality and safety of food. Participants are wary of the role of the food industry in food safety, believing that profit motives will undermine effective food regulation. Personal responsibility for food safety practices was also identified. While there are fewer mechanisms for consumer involvement and transparency built into the food governance system, Australian consumers display considerable trust in government to protect food safety. There is little evidence of the politicisation of food, reflecting a level of trust in the Australian food governance system that may arise from a lack of exposure to major food scares. [ABSTRACT FROM AUTHOR]

Abstract: This study explored children''s views about food advertising on television in the light of recent public interest in childhood obesity and obesogenic environments. Thirty-seven children aged between 8 and 11 years, discussed their perceptions of food advertising, in focus groups. The children engaged as consumers of advertising, noticing technical aspects, and expressing their likes and dislikes of particular techniques. While they understood the persuasive intent of advertising, they nevertheless desired products and made purchase requests. They particularly desired energy-dense nutrient-poor foods. The children demonstrated sophisticated levels of advertising literacy through their articulation of problems such as deception, impacts on children''s health and wellbeing, and family conflict. They revealed themselves as sentient beings, with the capacity to react, respond and reflect on their experience of advertising. This study makes a contribution to research on consumer socialisation by introducing the perspective of Australian children. As stakeholders in the childhood obesity problem, the views of children should also be of interest to health policymakers. [Copyright &y& Elsevier]

The article discusses three approaches that simplify public health policy analysis. A discussion of Bacchi's "What's the problem?" approach, Colebatch's governmentality approach and Bridgman and Davis' policy cycle approach, is presented. The impact that the three approaches can have on efforts to understand and become involved in public health policy work is discussed.

Objective: To develop a framework to guide action in the public health nutrition workforce to develop policies and practices addressing factors contributing to climate change. Design: Action/consultative research. Setting: Interviews - South Australia, questionnaire - Australia. Subjects: Interviews - key informants (n 6) were from various government, academic and non-government positions, invited through email. Questionnaire - participants were members of the public health nutrition workforce (n 186), recruited to the study through emails from public health nutrition contacts for each State in Australia (with the exception of South Australia). Results: Support by participants for climate change as a valid role for dietitians and nutritionists was high (78 %). However, climate change was ranked low against other public health nutrition priorities. Support of participants to conduct programmes to address climate change from professional and work organisations was low. The final framework developed included elements of advocacy/ lobbying, policy, professional recognition/support, organisational support, knowledge/skills, partnerships and programmes. Conclusions: This research demonstrates a need for public health nutrition to address climate change, which requires support by organisations, policy, improved knowledge and increased professional development opportunities. [ABSTRACT FROM AUTHOR]

Abstract: Childhood obesity is widely constructed as reaching epidemic proportions with consumption of fast food viewed as a contributing factor. This paper analyses media reporting of the regulation of fast food consumption to children. A media search of five Australian newspapers for the period January 2006 to June 2008 elicited 100 articles relating to the regulation of fast food advertising to children. Content and thematic analysis of the articles reveal conflicting perspectives on the role of the state; the level of accountability of the food and advertising industries; and responsibilities of parents for regulating fast food consumption in children. The Federal Government, food and advertising industries and free to air broadcasters favour industry self-regulation and personal responsibility for fast food consumption while the proponents of government regulation include consumer groups, state government health ministers, nutrition and public health academics and medical and health foundations. The regulation of fast food advertising to children is discussed in relation to ideas about governance and the public health strategies which follow from these ideas. The paper argues that all proposed solutions are indicative of a neoliberal approach to the governance of health insofar as the responsibility for regulation of food marketing is viewed as lying with industry and the regulation of lifestyle risk is viewed as an individual responsibility. [Copyright &y& Elsevier]

Abstract: Access to healthy food has become an important area of investigation for researchers interested in health disparities and inequalities. The debate about the existence and characteristics of ‘food deserts’ has increased the interest in food availability and equity in health research. This debate is crucial to an understanding of the factors leading to food security. Research reported here used in-depth interviews with respondents without private transport living within and outside food deserts in Adelaide, South Australia. The respondents came from a variety of households, including single and double parent families, and people living alone. The research found that living in a food desert did not, by itself, impose food access difficulties. Far more important was the access to independent transport to shops. A number of features were identified in this research including reliance on supermarkets, difficulties with public transport, and the provision of government schemes and systems that for some made food shopping much easier. The research suggests that food access problems in Adelaide are not so much the product of geographic distance between home and shop, as the social or welfare networks that allow people to access private transport. [Copyright &y& Elsevier]

Background: Due to the multifaceted aspect of child malnutrition, a comprehensive approach, taking social factors into account, has been frequently recommended in health literature. The Alma-Ata declaration explicitly outlined comprehensive primary health care as an approach that addresses the social, economic and political causes of poor health and nutrition. Iran as a signatory country to the Alma Ata Declaration has established primary health care since 1979 with significant progress on many health indicators during the last three decades. However, the primary health care system is still challenged to reduce inequity in conditions such as child malnutrition which trace back to social factors. This study aimed to explore the perceptions of the Iranian health stakeholders with respect to the Iranian primary health care performance and actions to move towards a comprehensive approach in addressing childhood malnutrition. Health stakeholders are defined as those who affect or can be affected by health system, for example health policy-makers, health providers or health service recipients. Methods: Stakeholder analysis approach was undertaken using a qualitative research method. Different levels of stakeholders, including health policy-makers, health providers and community members were interviewed as either individuals or focus groups. Qualitative content analysis was used to interpret and compare/contrast the viewpoints of the study participants. Results: The results demonstrated that fundamental differences exist in the perceptions of different health stakeholders in the understanding of comprehensive notion and action. Health policy-makers mainly believed in the need for a secure health management environment and the necessity for a whole of the government approach to enhance collaborative action. Community health workers, on the other hand, indicated that staff motivation, advocacy and involvement are the main challenges need to be addressed. Turning to community stakeholders, greater emphasis has been placed on community capabilities, informal link with other social sectors based on trust and local initiatives. Conclusion: This research provided a picture of the differences in the perceptions and values of different stakeholders with respect to primary health care concepts. The study suggests that a top-down approach, which still exists among health policymakers, is a key obstacle that delays, and possibly worse, undermines the implementation of the comprehensive strategy codified by the Alma-Ata Declaration. A need to revitalise primary health care to use its full potential and to combine top-down and bottom-up approaches by narrowing the gap between perceptions of policy makers and those who provide and receive health-related services is crucial. [ABSTRACT FROM AUTHOR]

The current preoccupation with body weight in western cultures is arguably unprecedented. The obesity crisis has engaged not only health communities, but numerous other public and private organisations, and, in so doing, has created moral alarm as well as a medical crisis. This paper examines the development of obesity and will discuss the ways in which fatness has been rationalised within health discourses. It will explore the way that the corpulent body, once historically considered as a physiological state, is now regarded as a state of moral pathology representing an 'epidemic'. The prospect of this disease sweeping through populations, reaching into virtually every social group, is presented as all the more frightening when no known effective prevention or cure is at hand. The paper will look at the ways in which new forms of government have developed with the panoptic capacity to gaze across populations and objectify the everyday activities of individuals. This 'government of girth' reaches an apogee in the problematisation of children and body weight. Three subject positions in childhood provide a number of opportunities to problematise children: the sick child, the anti-social child, and the innocent child. Each of these amplifies concern about the state of health of children, the permissive nature of parenting and potential moral social decay. [ABSTRACT FROM AUTHOR]

Objective: To explore consumer trust in food, especially people's experiences that support or diminish trust in the food supply; consumer practices to strengthen trust in food; and views on how trust in the food supply could be increased.Setting: Adelaide, South Australia.Design: In-depth qualitative research interviews and focus groups.Subjects: Women and men who are primary food providers in families (n = 24).Results: Media coverage of food scares and scandals and personal experience of food-borne illness challenged respondents' trust in the food system. Poor retail food handling practices and questionable marketing ploys by food manufacturers also decreased trust. Buying 'Made-in-Australia' produce and following food safety procedures at home were important practices to strengthen food trust. Knowledge of procedures for local food inspection and for national food regulation to keep food safe was scanty. Having a strong regulatory environment governing food safety and quality was considered by respondents to be of prime importance for trust building.Discussion: The dimensions of trust found in this study are consistent with key theoretical aspects of trust. The need for trust in highly complex environments, in this case the food supply, was evident. Trust was found to be integral to food choice, and negative media reports, the sources of which themselves enjoy various levels of dependability, were found to easily damage trust relationships. The lack of visibility of authoritative monitoring and surveillance, misleading food advertising, and poor retail food handling practices were identified as areas that decreased consumer trust. Respondents also questioned the probity of food labelling, especially health claims and other mechanisms designed to guide food choice. The research highlights the role trust plays in food choice. It also emphasises the importance of a visible authoritative presence in the food system to strengthen trust and provide reassurance to consumers. [ABSTRACT FROM AUTHOR]

Background: The role played by lay knowledge in understanding health inequalities has received increased interest recently. Very little is known, however, about how lay knowledge of food and health varies across social class. The present exploratory study compared and contrasted ways in which people from different social backgrounds draw on and use different forms of lay knowledge about food and health.Method: Parents from 40 families were recruited from two socio-economically different suburbs (20 families from each suburb). In-depth interviews were conducted with the mother and father in each family to examine lay knowledge about food and health. All interviews were transcribed and coded for specific themes. Responses from each suburb were compared and contrasted.Results: Different forms of lay knowledge about food and health were noted, especially concerning children's eating habits. Parents in the high-income suburb were more likely to discuss food and health in technical terms informed by contemporary nutritional or medical priorities. Parents in the low-income suburb did not share this discourse, but instead were more likely to discuss food in terms related to children's outward appearance or functional capacity.Conclusions and Implications: The research highlights differences in lay knowledge about food and health across social class. It emphasises the need for public health nutrition policy-makers and practitioners to pay attention to lay knowledge on its own terms, rather than attempting to educate from predetermined assumptions, principles and standards. [ABSTRACT FROM AUTHOR]

The term ‘capacity building’ is used in the health promotion literature to mean investing in communities, organizations and structures to enhance access to knowledge, skills and resources needed to conduct effective health programs. The Eat Well SA project aimed to increase consumption of healthy food by children, young people and their families in South Australia. The project evaluation demonstrated that awareness about healthy eating among stakeholders across a range of sectors, coalitions and partnerships to promote healthy eating and sustainable programs had been developed. The project achievements were analysed further using a capacity-building framework. This analysis showed that partnership development was a key strategy for success, leading to increased problem-solving capacity among key stakeholders and workers from education, child care, health, transport and food industry sectors. It was also a strategy that required concerted effort and review. New and ongoing programs were initiated and institutionalized within other sectors, notably the child care, vocational education and transport sectors. A model for planning and evaluating nutrition health promotion work is described. [ABSTRACT FROM AUTHOR]

Editorial. Focuses on the importance of food policy to public health. Regulation of food supply for a population; Protection of public health.

ABSTRACT Many public health interventions attempt to promote health and well-being while simultaneously engaging with or negating pleasureseeking activities. Yet the examination of pleasure is under-researched, especially within health and health-related areas. We examine pleasure as both an innate drive and a socially constructed phenomenon. Using the development of religious ideas in western cultures, we identify four forms of pleasure: carnal pleasure, disciplined pleasure, ascetic pleasure and ecstatic pleasure. These pleasures dramatically affect the construction of social and cultural identities. Moreover, they influence approaches to our understandings of health in general and interventions to public health in particular. The pursuit of the study of pleasure opens up a number of worthwhile areas for cross-disciplinary discussion and study. [ABSTRACT FROM AUTHOR]

Examines research on food and family life. Impact of marriage or cohabitation on food consumption and family life; Changes brought by parenthood on eating habits; Moral and social responsibilities associated with the feeding of infants.

This paper deals with the question: do some food systems engender a more positive social environment than others, and does this matter? The pressure to generate financial capital from food production is enormous, especially for a country like Australia, and financial imperatives clearly drive choice of food production methods. Many have argued that environmental costs of food production are hardly ever factored into the profitability equation and the notion of sustainable development represents a position where consideration is given to environmental concerns while at the same time maximizing economic returns. While the importance of choice of food system in order to benefit the natural environment has been argued for, another environment — that of the social environment — remains relatively underexplored. [ABSTRACT FROM AUTHOR]

Individuals who experience social isolation or loneliness report poorer psychological wellbeing and increased mortality than those who are socially connected. Older culturally and linguistically diverse (CALD) immigrants are a subgroup at greater risk of experiencing social isolation and loneliness. Many ethnic-focussed organizations in South Australia (SA) facilitate regular shared lunches, or "lunch clubs," to support older CALD immigrants. This study sought to understand the experiences of attending these lunch clubs, and the extent to which they influence perceived health and wellbeing of attendees. Four focus groups (n = 19) were held with individuals who regularly attended one of four cultural lunch clubs (Greek, Ukrainian, Chinese, Italian) in SA. Focus groups were conducted in English and participant's native language, with the assistance of accredited interpreters. Focus group transcripts were analyzed following a descriptive qualitative approach. Three themes were identified: A rare opportunity for social interaction, maintaining ties to culture in a foreign country, and fostering health and wellbeing. This study offers insight into lunch clubs as a potential intervention to reduce experiences of social isolation and loneliness in vulnerable populations. Future research is needed to measure the impact on health and wellbeing, and to model the most effective modes of delivery. [ABSTRACT FROM AUTHOR]

Abstract Public health nutrition programs have changed considerably over the past two decades. These changes have been most noticeable in approaches to program management, as well as the content, or the science, of public health nutrition. This paper documents these changes especially in the area of nutrition education, the new public health, and environmental issues related to the food supply. It stresses that in order to be effective, nutrition promotion for the public's health must broaden its definition of healthy food choices. No longer can these be understood solely in terms of the nutrient values of food. Recent outbreaks of foodborne disease have demonstrated that food safety concerns play a legitimate role in the promotion of healthy food. Moreover, a focus on environmental issues concerning the sustainability of the food supply should also play a major role in nutrition promotion. This paper concludes with an overview of the South Australian Food and Nutrition Project in which these issues are being addressed. The project has adopted a contemporary definition of healthy food choices which puts the theory of the art and science of public health nutrition into practice. (Aust J Nutr Diet 1999;56:151-155). [ABSTRACT FROM AUTHOR]

Regular family mealtimes are occasions to model food consumption and have been associated with health and well-being benefits for children. This study aimed to investigate children's mealtime food socialisation in socially diverse households. Nine families from France and five from Australia were recruited, ranging from lower middle-class to upper-class positions, with children mostly between the ages of five to eight. The data is composed of the observations of 47 mealtimes and semi-directive interviews with both parents. The results showed that food socialisation and parents' understanding of children's taste development were linked to the household's social class position as well as to the temporal, cognitive and emotional resources parents possessed at mealtimes, in a similar manner across France and Australia. The more capital and resources the parents had, the more they were able to perform an intensive food socialisation style, which led them to prepare balanced menus and get children to eat the food served. The less capital and resources the parents had, the more they engaged in a hands-off food socialisation style, leading them to serve more child-oriented and less diverse menus. Importantly, all parents strived to serve healthy food, but limited resources prevented some of them from doing so. These food socialisation styles were also connected to the development of different social skills in children: with the intensive model, children were closely managed by their parents at the table but also learnt negotiation skills, whereas with the hands-off style, children learnt to be quite autonomous in their eating. The findings presented here contribute to Hays' intensive mothering concept and to Lareau's class-based parenting models. They also challenge Bourdieu's differentiation between a taste of necessity and a taste of luxury. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify how dietitians and other healthcare providers work to build trust in food systems in the course of providing dietary education. Methods: Qualitative semi‐structured interviews were conducted with 15 purposefully sampled dietitians (n = 5), general practitioners (n = 5), and complementary and alternative medicine practitioners (n = 5) within metropolitan South Australia. Interview data were then interpreted using an inductive thematic analysis approach, involving the construction of themes representing trust‐enhancing roles around which beliefs about professional roles, the 'patient', and food and health were clustered. Results: Healthcare providers communicate beliefs regarding (dis)trust in food systems through: (i) responding to patient queries and concerns following a food incident or scare; (ii) helping patients to identify (un)trustworthy elements of food supply systems; and (iii) encouraging consumption of locally produced and minimally processed food. Importantly, the expression of these roles differed according to participant beliefs about food and health (medico‐scientific versus alternative medicine) and their adoption of professional projects that sought to promote medico‐scientific ways of thinking about health and diet or manage the failures of Western medicine. Conclusion: The development and consolidation of trust‐enhancing roles amongst healthcare providers likely requires disciplinary reflection on professional values and the processes by which practitioners apply these values to understanding food systems. [ABSTRACT FROM AUTHOR]

This multi-method project examined how Australian caregivers navigated family life during the COVID-19 pandemic in 2020 and subsequent impact on family health behaviours. Participants were invited to complete all three phases. In phase 1, 115 caregivers completed an online survey, focussed on 2020 experiences of COVID-19. In phase 2, 96 of the participants completed a use-of-time recall and 80 completed a dietary recall examining participants' health behaviours including how they spent their time, their physical activity, and diet quality. Phase 3 involved 24 of the participants completing an online story completion task, focussed on understanding participants' sense-making of COVID-19. Through triangulating analyses of the three phases, this project identified how poor relationship quality negatively affected families' experiences of significant disruptions and transitions. This project provides a nuanced picture of how COVID-19 in 2020 impacted family life and highlights the importance of caregiver relationship quality for family health and wellbeing. [ABSTRACT FROM AUTHOR]

This article contributes to the sociology of relationships by exploring the moral imperatives that shaped perceptions and negotiations of family life during lockdowns in Australia during the COVID-19 pandemic. We identified dominant discourses from an online qualitative story completion task and situate these in relation to emerging literature on the impact of pandemic-related restrictions on domestic relationships, gender relations, and labour division. We argue that discourses of family connection, clean and tidy homes, and the commodity of time operated as moral imperatives. These imperatives simultaneously offered opportunities for enrichment and agency, as well as operating as unobtainable benchmarks that constrained people’s sense of wellbeing. In this analysis we explore how COVID-19 lockdown stories offer new ways of understanding the interplay between displaying and doing ‘family life’ where gender and labour relations are performed, reinforced and challenged. [ABSTRACT FROM AUTHOR]

Issue addressed: Considerable public effort has been directed at centre‐based childcare as an early childhood education and care (ECEC) setting to promote healthy food‐related behaviours in young children. However, in the real‐world setting, best practice, evidence‐based guidelines are not always well‐translated into usual, day‐to‐day routines. This study aims to understand what factors influence the centre‐based childcare cooks' food and nutrition decisions for children aged 2‐5 years. Methods: Semi‐structured qualitative interviews were conducted with cooks in centre‐based childcare using purposeful maximum variation sampling and data analysed thematically. Results: Fourteen cooks were interviewed from 14 services across South Australia. Central to providing a healthy food environment was expert‐led knowledge and training gained through the workplace over several years and the embodiment of the service's healthy food and nutrition policy, evidenced through menu planning to maintain a focus on healthy eating. Threatening these positive, routine practices and decisions were pressures to modify menus in response to increasing food allergies and changing cultural and family preferences, in the absence of ongoing relevant training and expertise at the system‐level. Conclusions: Children in ECEC benefit from cooks' commitment to providing nutritious foods; however, the requirements to extend their role to respond to increasing demands without relevant system‐level support and training puts the children at risk of not being exposed to health‐promoting menus and possible errors in providing dietary modifications. ECEC cooks urgently need access to system‐level support and training. So What?: Understanding and addressing the barriers experienced by cooks and the complexity of factors that inform their food‐related decision‐making will sustain the implementation of effective, healthy eating guidelines and nutrition practices in ECEC. [ABSTRACT FROM AUTHOR]

Australian women shoulder the bulk of household duties including family food provisioning, despite increasing participation in the workforce. This research aimed to understand employed mothers' daily-lived experience of family food provisioning, in particular, the intersection between family food provisioning, gender inequality and nutritional guidelines as they impact women's time and health. Semi-structured interviews were conducted with 22 employed mothers in South Australia. Participants had at least one child aged less than 13 years. Qualitative data was analysed using a thematic content approach. Time-scarcity was common and associated with stress in relation to family food provisioning; this relationship was particularly apparent among employed mothers who were also studying. Most mothers valued nutrition and strove to provide nutritious meals, although they tended to work from their own nutritional understandings, not the national nutrition guidelines; they saw the nutrition guidelines as unhelpful because of the time demands that were implied. The study invites policy makers, practitioners and researchers to consider time for family food provisioning as a social determinant of family as well as women's health, and structural strategies to address this health inequity for women. [ABSTRACT FROM AUTHOR]

Consumer trust in the modern food system is essential given its complexity. Contexts vary across countries with regard to food incidents, regulation and systems. It is therefore of interest to compare how key actors in different countries might approach (re)building consumer trust in the food system; and particularly relevant to understanding how food systems in different regions might learn from one another. The purpose of this paper is to explore differences between strategies for (re)building trust in food systems, as identified in two separate empirical studies, one conducted in Australia, New Zealand and the UK (Study 1) and another on the Island of Ireland (Study 2). Interviews were conducted with media, food industry and food regulatory actors across the two studies (n  = 105 Study 1; n  = 50 Study 2). Data were coded into strategy statements, strategies describing actions to (re)build consumer trust. Strategy statements were compared between Studies 1 and 2 and similarities and differences were noted. The strategy statements identified in Study 1 to (re)build consumer trust in the food system were shown to be applicable in Study 2, however, there were notable differences in the contextual factors that shaped the means by which strategies were implemented. As such, the transfer of such approaches across regions is not an appropriate means to addressing breaches in consumer trust. Notwithstanding, our data suggest that there is still capacity to learn between countries when considering strategies for (re)building trust in the food system but caution must be exercised in the transfer of approaches. [ABSTRACT FROM AUTHOR]

Recovery colleges are formal learning programs that aim to support people with a lived experience of mental illness. In this study, we aimed to explore the experiences of participants in a pilot recovery college that opened in Adelaide, South Australia, in 2016. A qualitative exploratory study was conducted involving interviews with learners (n = 8) and focus groups with lived experience facilitators (course facilitators with a lived experience of mental illness, n = 5), Clinician facilitators (mental health service staff facilitators, n = 4), and care coordinators (staff providing case management support, n = 5). Three main themes (hope, identity, and the recovery college as a transition space) and two subthemes (recovery college experience and outcomes) were identified. The results showed that the recovery college provided a transition space for shifting learners' identities from patient to student, facilitated by the experiences and outcomes of the recovery college, providing hope for the future. This study highlights the importance of providing mentally healthy and non‐stigmatizing learning environments to promote and cement recovery for people with a lived experience of mental illness. [ABSTRACT FROM AUTHOR]

Family meals are recognized as an opportunity to promote the health of families. Popular discourse posits that changes to contemporary family life have made family meals harder to achieve and promotion of the 'traditional' family meal may be adding pressures to contemporary families. While research has been conducted on family meals over the last three decades, there is no explicit investigation of the experiences and practices of family meals over this time. Understanding the evolution of family meal practices across time is important for developing achievable expectations in relation to this ritual. Qualitative interviews were conducted with a diverse population of South Australian parents in the 1990s (n  = 32) and with a separate population of parents in 2020 (n  = 22) to gather their experiences of family meal practices. A comparative analysis, informed by grounded theory, was undertaken to identify similarities and differences in experiences across these two time periods. The results indicated stability in many family meal experiences across time, particularly in their value and significance in family life. Negotiations balancing time, cost, food preferences and responsibility persisted. The stability of family meal values and practices is important to consider when making recommendations, designing interventions and creating services targeting the family meal. [ABSTRACT FROM AUTHOR]

Abstract Researchers and food system actors have developed a best practice model to assist with (re)building or maintaining consumer trust in the food system in the event of a food incident. The aim of the present study was to determine how well the model aligns with consumer views of the strategies required to maintain consumer trust during and following a food incident. This qualitative public deliberation study employed experimental, developmental vignettes during 2 full-day sessions in May 2018. Following general discussion of the food incident scenario presented in the vignettes, 15 South Australian adults (in two groups) developed a collated and ranked list of key strategies to be used by food system actors during a food incident to assist in maintaining consumer trust. Participants were then introduced to the existing model, and engaged in discussions about if and how their strategies aligned with those in the existing model. Findings demonstrate broad consistency between the two groups and the model in the strategies identified as key for (re)building and maintaining consumer trust during a food incident. For example, timely transparency was reported by consumers as the key strategy for maintaining consumer trust during and after a food incident. However, participants expressed pessimism regarding actors' ability to implement strategies. Although minimal, differences were noted in strategy descriptions between the groups and the Model. This study suggests that overall the model is highly consistent with consumer views. If actors are to demonstrably apply the Model in the event of a food incident, our data suggest that the identified strategies will successfully assist them in (re)building and/or maintaining consumer trust in the food supply. Highlights • Timely transparency is the key strategy for consumer trust during a food incident. • Consumers and food actors propose similar strategies for maintaining consumer trust. • Consumers express pessimism regarding food actors' ability to implement strategies. [ABSTRACT FROM AUTHOR]