BackgroundPrice and affordability of foods are important determinants of health. Targeted food pricing policies may help improve population diets. However, methods producing comparable data to inform relevant policy decisions are lacking in Australia and globally. The objective was to develop and pilot standardised methods to assess the price, relative price and affordability of healthy (recommended) and current (unhealthy) diets and test impacts of a potential policy change.MethodsMethods followed the optimal approach proposed by INFORMAS using recent Australian dietary intake data and guidelines. Draft healthy and current (unhealthy) diet baskets were developed for five household structures. Food prices were collected in stores in a high and low SES location in Brisbane, Australia. Diet prices were calculated and compared with household incomes, and with potential changes to the Australian Taxation System. Wilcoxen-signed rank tests were used to compare differences in price.ResultsThe draft tools and protocols were deemed acceptable at household level, but methods could be refined. All households spend more on current (unhealthy) diets than required to purchase healthy (recommended) diets, with the majority (53–64 %) of the food budget being spent on ‘discretionary’ choices, including take-away foods and alcohol. A healthy diet presently costs between 20–31 % of disposable income of low income households, but would become unaffordable for these families under proposed changes to expand the GST to apply to all foods in Australia.ConclusionsResults confirmed that diet pricing methods providing meaningful, comparable data to inform potential fiscal and health policy actions can be developed, but draft tools should be refined. Results suggest that healthy diets can be more affordable than current (unhealthy) diets in Australia, but other factors may be as important as price in determining food choices.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2996-y) contains supplementary material, which is available to authorized users.

BackgroundThis paper describes the rationale, development and final protocol of the Healthy Diets Australian Standardised Affordability and Pricing (ASAP) method which aims to assess, compare and monitor the price, price differential and affordability of healthy (recommended) and current (unhealthy) diets in Australia. The protocol is consistent with the International Network for Food and Obesity / non-communicable Diseases Research, Monitoring and Action Support’s (INFORMAS) optimal approach to monitor food price and affordability globally.MethodsThe Healthy Diets ASAP protocol was developed based on literature review, drafting, piloting and revising, with key stakeholder consultation at all stages, including at a national forum.DiscussionThe protocol was developed in five parts. Firstly, for the healthy (recommended) and current (unhealthy) diet pricing tools; secondly for calculation of median and low-income household incomes; thirdly for store location and sampling; fourthly for price data collection, and; finally for analysis and reporting. The Healthy Diets ASAP protocol constitutes a standardised approach to assess diet price and affordability to inform development of nutrition policy actions to reduce rates of diet-related chronic disease in Australia. It demonstrates application of the INFORMAS optimum food price and affordability methods at country level. Its wide application would enhance monitoring and utility of dietary price and affordability data from a health perspective in Australia. The protocol could be adapted in other countries to monitor the price, price differential and affordability of current and healthy diets.Electronic supplementary materialThe online version of this article (10.1186/s12937-018-0396-0) contains supplementary material, which is available to authorized users.

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Background The perception that healthy foods are more expensive than unhealthy foods has been reported widely to be a key barrier to healthy eating. However, assessment of the relative cost of healthy and unhealthy foods and diets is fraught methodologically. Standardised approaches to produce reliable data on the cost of total diets and different dietary patterns, rather than selected foods, are lacking globally to inform policy and practice. Methods This paper reports the first application, in randomly selected statistical areas stratified by socio-economic status in two Australian cities, of the Healthy Diets Australian Standardized Affordability and Pricing (ASAP) method protocols: diet pricing tools based on national nutrition survey data and dietary guidelines; store sampling and location; determination of household incomes; food price data collection; and analysis and reporting. The methods were developed by the International Network on Food and Obesity/NCD Research, Monitoring and Action Support (INFORMAS) as a prototype of an optimum approach to assess, compare and monitor the cost and affordability of diets across different geographical and socio-economic settings and times. Results Under current tax policy in Australia, healthy diets would be 15–17% less expensive than current (unhealthy) diets in all locations assessed. Nevertheless, healthy diets are likely to be unaffordable for low income households, costing more than 30% of disposable income in both cities surveyed. Households spent around 58% of their food budget on unhealthy food and drinks. Food costs were on average 4% higher in Canberra than Sydney, and tended to be higher in high socioeconomic locations. Conclusions Health and fiscal policy actions to increase affordability of healthy diets for low income households are required urgently. Also, there is a need to counter perceptions that current, unhealthy diets must be less expensive than healthy diets. The Healthy Diets ASAP methods could be adapted to assess the cost and affordability of healthy and unhealthy diets elsewhere.

Cough stress tests were accurate to diagnose urodynamic stress urinary incontinence. The 24-hour pad test was not predictive of urodynamic stress urinary incontinence and not helpful when used in conjunction with the cough stress test.

The prevalence of malnutrition and nutritional risk of Australian paediatric inpatients on a given day was much higher when compared with the healthy population. In contrast, the proportion of overweight and obese patients was less.

Background Prior studies of resident experience in gynecology looked only at the year before and after adoption of ACGME duty hour standards. This study sought to determine whether procedure volume differed after completion of a 4-year residency training program, before and after work hour reform. Method Inpatient and outpatient procedures performed by MetroHealth Medical Center/Cleveland Clinic program residents from 1998 to 2006 were obtained from Annual Reports of Institutional and Resident Experience. Four-year experience before and after duty hour restrictions were compared: hours worked were collected from resident schedules, ambulatory hours and procedures were compared directly, surgical procedures and deliveries were compared using a 2-tailed t test. Data were also obtained for institutional volume changes, and a corrected value, based on the rates of resident cases per available cases, was analyzed. Results Ambulatory hours worked per resident decreased after implementing work hour reform from 674 to 366 hours. The types of ambulatory and surgical procedures performed varied over time. Overall, basic surgical and obstetrical volume per resident did not change before and after work hour reform (mean before reform, 723 ± 117, mean after reform, 781 ± 200, P  =  .58 for gynecologic procedures; mean before reform, 611 ± 107, mean after reform, 535 ± 73, P  =  .18 for basic obstetrics and vaginal and cesarean deliveries). Institutional volume did not change significantly, although the percentage of the institutions' cases performed by residents did decrease for some procedures. Conclusion The ACGME duty hour restrictions do not limit the overall ambulatory or surgical procedural volume in an obstetrics and gynecology residency-training period.

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