Food insecurity: Discrepancy within Australian couple households

© 2024 The Authors. Australian Journal of Social Issues published by John Wiley & Sons Australia, Ltd on behalf of Australian Social Policy Association. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Food security remains a global public health priority but there may be bias in the prevalence of household food insecurity, depending upon who answers the questions. Using a cross‐section from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, we analysed components of food insecurity reported separately by both partners in 718 households, allowing examination of discrepancies among couples. We modelled discrepancy in reports of food insecurity on 8 items using binary logit models for each question and a binomial regression for the number of questions on which there was discrepancy. Among couples who differed on an item, (conditional) discrepancy rates ranged from 71.75% to 85.86%. Females were more likely than males to report food insecurity on most items. Key characteristics associated with discrepancy were female's and male's age, female's education, being born in Australia, renting and male's employment. Male's age and birthplace were associated with discrepancy on more items while male's higher education and being a homeowner were associated with discrepancy on fewer items. Among couples who differed in responses, females were more likely to report food insecurity if they were older or had a disability, if their male partner was younger or had no disability, or if either person had more education than high school. The prevalence of food insecurity among couple households may be underestimated by 7.4 percentage points due to discrepancies in reporting. Discrepancies can reduce the accuracy of measures of food insecurity, impeding the targeting of responses, and lead to a less efficient allocation of resources to combat food insecurity.Peer reviewe

Telling partners about chlamydia: how acceptable are the new technologies?

BACKGROUND Partner notification is accepted as a vital component in the control of chlamydia. However, in reality, many sexual partners of individuals diagnosed with chlamydia are never informed of their risk. The newer technologies of email and SMS have been used as a means of improving partner notification rates. This study explored the use and acceptability of different partner notification methods to help inform the development of strategies and resources to increase the number of partners notified. METHODS Semi-structured telephone interviews were conducted with 40 people who were recently diagnosed with chlamydia from three sexual health centres and two general practices across three Australian jurisdictions. RESULTS Most participants chose to contact their partners either in person (56%) or by phone (44%). Only 17% chose email or SMS. Participants viewed face-to-face as the "gold standard" in partner notification because it demonstrated caring, respect and courage. Telephone contact, while considered insensitive by some, was often valued because it was quick, convenient and less confronting. Email was often seen as less personal while SMS was generally considered the least acceptable method for telling partners. There was also concern that emails and SMS could be misunderstood, not taken seriously or shown to others. Despite these, email and SMS were seen to be appropriate and useful in some circumstances. Letters, both from the patients or from their doctor, were viewed more favourably but were seldom used. CONCLUSION These findings suggest that many people diagnosed with chlamydia are reluctant to use the new technologies for partner notification, except in specific circumstances, and our efforts in developing partner notification resources may best be focused on giving patients the skills and confidence for personal interaction.The study was funded by the Australian Federal Government Department of Health and Ageing Chlamydia Pilot Program of Targeted Grants

Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

BACKGROUND Genital chlamydia is the most commonly notified sexually transmissible infection (STI) in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT) has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs) are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs) in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis. METHODS In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs) from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT.Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed. RESULTS Perceived barriers to patients telling partners (patient referral) included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral) included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT--many felt concerned that it is not best clinical practice but many also felt that it is better than nothing.GPs identified the following factors which they considered would facilitate partner notification: clear clinical guidelines; a legal framework around partner notification; a formal chlamydia screening program; financial incentives; education and practical support for health professionals, and raising awareness of chlamydia in the community, in particular amongst young people. CONCLUSIONS GPs reported some partners do not seek medical treatment even after they are notified of being a sexual contact of a patient with chlamydia. More routine use of PDPT may help address this issue however GPs in this study had negative attitudes to the use of PDPT. Appropriate guidelines and legislation may make the use of PDPT more acceptable to Australian GPs.The Australian Federal Government Department of Health and Ageing Chlamydia Pilot Program of Targeted Grants funded the study

Factors that Influence the Sociological Construct of Adulthood in Adults with Moderate Intellectual Disabilities (ID): An ID Case Study

The most common criteria used to evaluate successful transition into adulthood for young adults have included obtaining employment and establishing autonomous non-relative social support networks (correlate to community involvement). Hence, employment and community involvement are critical in the transition to adulthood for all young adults, including those with intellectual disabilities (ID). However, with respect to those with ID, the construct of Adulthood is multi-faceted and murky. Hence, this exploratory study seeks to determine factors (measured by the Transition Planning Inventory-2) that impact the sociological construct of Adulthood in young adults with ID and to model pictorially the relationship between them. Results indicate for adults with ID, vocational purpose, community involvement, and wellness explain 47% of the variance in the sociological construct of Adulthood. Factor analysis reveals that vocational purpose is characterized by employment and self determination; community involvement by leisure activity, community participation, and interpersonal relationships; and wellness by health and daily living

Polypharmacy: Misleading, but manageable

The percentage of the population described as elderly is growing, and a higher prevalence of multiple, chronic disease states must be managed concurrently. Healthcare practitioners must appropriately use medication for multiple diseases and avoid risks often associated with multiple medication use such as adverse effects, drug/drug interactions, drug/disease interactions, and inappropriate dosing. The purpose of this study is to identify a consensus definition for polypharmacy and evaluate its prevalence among elderly outpatients. The authors also sought to identify or develop a clinical tool which would assist healthcare practitioners guard against inappropriate drug therapy in elderly patients. The most commonly cited definition was a medication not matching a diagnosis. Inappropriate was part of definitions used frequently. Some definitions placed a numeric value on concurrent medications. Two common definitions (ie, 6 or more medications or a potentially inappropriate medication) were used to evaluate polypharmacy in elderly South Carolinians (n = 1027). Data analysis demonstrates that a significant percentage of this population is prescribed six or more concomitant drugs and/or uses a potentially inappropriate medication. The findings are 29.4% are prescribed 6 or more concurrent drugs, 15.7% are prescribed one or more potentially inappropriate drugs, and 9.3% meet both definitions of polypharmacy used in this study. The authors recommend use of less ambiguous terminology such as hyperpharmacotherapy or multiple medication use. A structured approach to identify and manage inappropriate polypharmacy is suggested and a clinical tool is provided

Management of Chlamydia Cases in Australia (MoCCA): protocol for a non-randomised implementation and feasibility trial

INTRODUCTION: The sexually transmitted infection chlamydia can cause significant complications, particularly among people with female reproductive organs. Optimal management includes timely and appropriate treatment, notifying and treating sexual partners, timely retesting for reinfection and detecting complications including pelvic inflammatory disease (PID). In Australia, mainstream primary care (general practice) is where most chlamydia infections are diagnosed, making it a key setting for optimising chlamydia management. High reinfection and low retesting rates suggest partner notification and retesting are not uniformly provided. The Management of Chlamydia Cases in Australia (MoCCA) study seeks to address gaps in chlamydia management in Australian general practice through implementing interventions shown to improve chlamydia management in specialist services. MoCCA will focus on improving retesting, partner management (including patient-delivered partner therapy) and PID diagnosis. METHODS AND ANALYSIS: MoCCA is a non-randomised implementation and feasibility trial aiming to determine how best to implement interventions to support general practice in delivering best practice chlamydia management. Our method is guided by the Consolidated Framework for Implementation Research and the Normalisation Process Theory. MoCCA interventions include a website, flow charts, fact sheets, mailed specimen kits and autofills to streamline chlamydia consultation documentation. We aim to recruit 20 general practices across three Australian states (Victoria, New South Wales, Queensland) through which we will implement the interventions over 12–18 months. Mixed methods involving qualitative and quantitative data collection and analyses (observation, interviews, surveys) from staff and patients will be undertaken to explore our intervention implementation, acceptability and uptake. Deidentified general practice and laboratory data will be used to measure pre-post chlamydia testing, retesting, reinfection and PID rates, and to estimate MoCCA intervention costs. Our findings will guide scale-up plans for Australian general practice. ETHICS AND DISSEMINATION: Ethics approval was obtained from The University of Melbourne Human Research Ethics Committee (Ethics ID: 22665). Findings will be disseminated via conference presentations, peer-reviewed publications and study reports

The economic impact of the Department of Energy on the state of New Mexico fiscal year 1997

The US Department of Energy (DOE) provides a major source of economic benefits in New Mexico. The agency`s far-reaching economic influence within the state is the focus of this report. Economic benefits arising from the various activities and functions of both DOE and its contractors have accrued to the state continuously for over 50 years. For several years, DOE/Albuquerque Operations Office (AL) and New Mexico State University (NMSU) have maintained inter-industry, input-output modeling capabilities to assess DOE`s impacts on the state of New Mexico and the other substate regions most directly impacted by DOE activities. One of the major uses of input-output techniques is to assess the effects of developments initiated outside the economy such as federal DOE monies that flow into the state, on an economy. The information on which the models are based is updated periodically to ensure the most accurate depiction possible of the economy for the period of reference. For this report, the reference periods are Fiscal Year (FY) 1996 and FY 1997. Total impacts represents both direct and indirect impacts (respending by business), including induced (respending by households) effects. The standard multipliers used in determining impacts result from the inter-industry, input-output models uniquely developed for New Mexico. This report includes seven main sections: (1) introduction; (2) profile of DOE activities in New Mexico; (3) DOE expenditure patterns; (4) measuring DOE/New Mexico`s economic impact; (5) technology transfer within the federal labs funded by DOE/New Mexico; (6) glossary of terms; and (7) technical appendix containing a description of the model. 9 figs., 19 tabs

The economic impact of Sandia National Laboratories on central New Mexico and the state of New Mexico fiscal year 1997

Sandia National Laboratories (SNL) was established in 1949 to perform the engineering development and ordnance responsibilities associated with nuclear weapons. By the early 1960`s the facility had evolved into an engineering research and development laboratory and became a multiprogram laboratory during the 1970s. Sandia is operated for the US Department of Energy by the Sandia Corporation, a wholly-owned subsidiary of Lockheed Martin, Incorporated. For several years, the US Department of Energy (DOE) Albuquerque Operations Office (AL) and New Mexico State University (NMSU) have maintained an inter-industry, input-output model with capabilities to assess the impacts of developments initiated outside the economy such as federal DOE monies that flow into the state, on an economy. This model will be used to assess economic, personal income and employment impacts of SNL on central New Mexico and the state of New Mexico. For this report, the reference period is FY 1997 (October 1, 1996, through September 30, 1997) and includes two major impact analyses: the impact of SNL activities on central New Mexico and the economic impacts of SNL on the state of New Mexico. For purposes of this report, the central New Mexico region includes Bernalillo, Sandoval, Valencia, and Torrance counties. Total impact represents both direct and indirect respending by business, including induced effects (respending by households). The standard multipliers used in determining impacts results from the inter-industry, input-output models developed for the four-county region and the state of New Mexico. 6 figs., 10 tabs