Retail Premises Research Articles

An unintended consequence of COVID-19 immunity passports-quasi-experimental evidence of moral hazard observed after implementing the domestic Green Pass policy during the second wave of the COVID-19 pandemic in Italy.

Amidst the second wave of the COVID-19 pandemic, Italian policymakers mandated to exhibit evidence of vaccination or immunity (the Green Pass) as a condition to access retail premises and public offices. This study aims to offer evidence, in a quasi-experimental setting, suggesting that an unintended consequence of this policy was the emergence of moral hazard. Google visit duration data measured the time customers typically spend on retail premises or public offices. A pairwise comparison of median visit time per premise was performed at a six-week interval before and after the introduction of the Green Pass. This study is the first to provide evidence of "ex-post" moral hazard associated with introducing a domestic Green Pass policy. The median visiting time on premises that required digital immunity control significantly increased after introducing the domestic Green Pass policy, contrary to other public premises where access remained free of limitations. The increase in median visit time in premises with faster customer turnaround, such as coffee shops (+49%) and fast-food restaurants (+45%), was lower than the increase observed for fine-dining restaurants (+74%) and pizzerias (+163%). No significant increase in median visit time was observed in premises where the Green Pass was not required, such as food supermarkets, retail non-food shops, post offices, banks, pharmacies, and gas stations. The evidence of moral hazard highlights the critical issue of unintended consequences stemming from public health policies. This discovery is pivotal for policymakers, indicating that unforeseen behavioral adjustments could offset the intended benefits despite the intent to reduce risk through measures like the Green Pass.

Living rooms: Anne Tallentire’s Material Distance

Cultural geography has a long and fruitful tradition of working at the intersections between geography and performance art: in this piece we build upon this by considering how artistic practice can shed light on the housing crisis via a focus on quotidian practices of housing design. Here, we focus on Anne Tallentire’s exhibition Material Distance, which took place in 2022–23 at the John Hansard Gallery, Southampton, UK. A conceptual artist working with moving image, installation, performance and photography, Tallentire’s work has frequently addressed issues of spatial cognition, homemaking and transience. Material Distance extends this interest by foregrounding issues of housing size, adopting the abstract forms of representation – floorplans, measurements, technical drawings – which professionals use for determining the material and physical requirements of domestic inhabitation. Contrasting abstract and lived experiences of home, and comparing housing constructed on post-war council estates with some of the smaller homes recently converted from industrial or retail premises, Tallentire’s work invites us to develop a critical awareness of dimensionality through an embodied encounter with art that is relational, performative and experiential.

Stocking Practices of Anti-Tuberculosis Medications among Community Pharmacists and Patent Proprietary Medicine Vendors in Two States in Nigeria.

Evidence has shown that non-fixed-dose combination (non-FDC) anti-TB drugs could promote the spread of drug-resistant tuberculosis (DR-TB). We aimed to determine anti-TB medication stocking and dispensing practices among patent medicine vendors (PMVs) and community pharmacists (CPs) and their determinants. This was a cross-sectional study using a structured, self-administered questionnaire among 405 retail outlets (322 PMVs and 83 CPs) across 16 Lagos and Kebbi local government areas (LGAs) between June 2020 and December 2020. Data were analyzed with Statistical Program for Social Sciences (SPSS) for Windows version 17 (IBM Corp., Armonk, NY, USA). Chi-square test and binary logistic regression were used to assess the determinants of anti-TB medication stocking practices at a p-value of 0.05 or less for statistical significance. Overall, 91%, 71%, 49%, 43% and 35% of the respondents reported stocking loose rifampicin, streptomycin, pyrazinamide, isoniazid and ethambutol tablets, respectively. From bivariate analysis, it was observed that being aware of directly observed therapy short course (DOTS) facilities (OR 0.48, CI 0.25-0.89, p < 0.019) and having previous training on TB (OR 0.32, CI 0.14-0.73, p < 0.005) reduced the odds of stocking anti-TB medication, while operating more than 1 shop (OR 3.32, CI 1.44-7.57, p = 0.004), having 3 or more apprentices (OR 5.31, CI 2.74-10.29, p < 0.001) and seeing over 20 clients/day (OR 3.02, CI 1.18-7.71, p = 0.017) increased the odds of stocking loose anti-TB medications. From multivariate analysis, it was observed that only the variable having three or more apprentices (OR 10.23, CI 0.10-0.49, p = 0.001) significantly increased the odds of stocking anti-TB medications. The stocking of non-FDC anti-TB medications was high and largely determined by the number of apprentices among PMVs and CPs in Nigeria, and this may have serious implications for drug resistance development. However, the results linking the stocking of anti-TB to the number of apprentices should be interpreted cautiously as this study did not control for the level of sales in the pharmacies. We recommend that all capacity-building and regulatory efforts for PMVs and CPs in Nigeria should include not just the owners of retail premises but also their apprentices.

The hidden city of immigrants in Helsinki's urban leftovers – the homogenization of the city and the lost diversity

Cities acknowledge the diversity of their population and consider the multicultural component a richness of their socio-cultural assets. Immigrants contribute to the reshaping of urban space in many European cities through their amenities. Such amenities, be they secular or spiritual, are a clear spatialization of multiculturalism. Ethnic retail is an emerging phenomenon in Helsinki, and it has increasingly replaced declining independent mainstream retail. Often, clusters of immigrant amenities are formed around Muslim prayer rooms activating a mosque-bazaar alliance that enjoys a dynamic footfall. Such a setting takes place spontaneously and typically at abandoned spaces, called in this dissertation urban leftovers. The leftovers are located in, or nearby, the neighbourhoods with a relative overrepresentation of immigrant population. However, these neighbourhoods are exposed to urban renewal steered by anti-segregation policy, thus facing the threat of erasure. This dissertation examines the capacity of urban planning to plan for diversity. It further studies the characteristics that ethnic retail requires to survive and emerge. The paradigm of The Right to the City is deployed to interpret the response of urban planning to multiculturalism. The findings are numerous. First, immigrant amenities prove their capability to play a role in place making and act as catalysts for public life recovery. Second, in doing so the created places not only fulfil the socio-cultural needs of immigrants, but they also attract mainstream clientele. Third, spontaneity, improvisation and authenticity are the main characteristics empowering the emergence of ethnic retail. However, the findings also show a failure of urban planning to reflect multiculturalism in the growth of the city. Often, the retail premises used by immigrants are demolished. Furthermore, conventional planning as well as alternative planning methods, such as scenario planning and urban planning competitions, have failed to reflect immigrants in the development. The main constraint preventing planning from being multicultural is the absence of a political interest and, accordingly, a clear vision to deal with the spatialization of multiculturalism. On the contrary, the clear vision of the city is its anti-segregation policy, which is by nature a homogenizing mechanism. Thus, the dissertation concludes that immigrants' Right to the City has been ignored.

Exploring multi-stakeholder value co-creation as an entrepreneurial approach to survival and sustainability: The case of Pennine Pubs

This case focuses on the entrepreneurial use of multi-stakeholder value co-creation to emerge stronger from challenging trading conditions. In particular, it examines Pennine Pubs, a small-/medium-sized enterprise (SME) operating several rural public houses, which are licensed to sell food and alcoholic drinks to guests. Based in Northern England, it has adapted commercial strategies to mitigate government-enforced Covid-19 lockdowns. Pennine Pubs’ Managing Director is currently considering how to build upon the multi-stakeholder value co-creation strategy which emerged quickly immediately before and during the first lockdown period, when customers were prohibited from visiting pubs. He expects the outcome to be a more refined and sustainable commercial strategy which retains the most significant benefits of his lockdown-period innovations. The case considers how co-creation is applied as a reaction to unforeseen business challenges, and how it can underpin proactive strategies to capitalise upon favourable trading conditions. The concept is explored in the context of rapidly evolving, unpredictable and highly problematic constraints upon retail trade, and the ‘new normal’ of customers returning to retail premises, albeit with expectations modified by recent experiences. Finally, the case considers the impact of SMEs collaborating with suppliers, customers and other stakeholders to co-create mutual, commercially sustainable value.

Retail Apocalypse as a Differential Urbanisation Symptom? Analysis of Ground Floor Premises’ Evolution in Barcelona between 2016 and 2019

The current health and economic crisis resulting from the COVID-19 pandemic has accentuated some of the trends that began with the counter-reform of capitalism in 1970. This paper deals with one of those trends—the retail apocalypse. The starting hypothesis is that this phenomenon takes part in an implosion (the massive and permanent closing of retail premises in agglomeration) and an explosion (a change of land uses in an urban agglomeration and beyond). In order to determine the reach of those trends, the last two commercial censuses of the City Council (2016 and 2019) are analysed using a one-to-one relation matrix and map representation. This phenomenon, which is not just economic but also urban, is expressed differentially according to the dynamics between the upper and lower circuits of the urban economy. An implosion is detected as a general form for the whole city; in contrast, an explosion is expressed in more dynamic areas.

The Use of Geoinformation Collections of Prices and Pricing Variables in the Forensic Examination of Cadastral Valuation of Real Estate

The article offers a simple and descriptive approach to automating of solving the tasks of forensic examination of cadastral valuation of commercial real estate: office, retail, and warehouse premises. The authors address the application of geoinformation methods and assessment quality control. They provide a description of preliminary data processing methods, as well as construction of spatial rasters of real estate prices in various groups. For the first time, the arithmetic of spatial rasters for constructing the main multipliers and coefficients of the commercial real estate market has been studied. The proposed model will enable the forensic expert institutions of the Russian Ministry of Justice to adequately respond to the challenges of the time: to increase the volume and quality of expertise production while reducing their time. Government agencies and large consumers of valuation services will be able to significantly improve the efficiency of management, reduce the risks of underestimation or overestimation of transaction prices associated with the lack of transparency of evaluation results, collusion with interested parties, and appraisers will be able to improve the quality and cost of their service.

Effect of Accessibility on Commercial Property Rental Values Performance in Oja Oba Market, Ilorin Metropolis

The value of a commercial property is mainly determined by its inter-accessibility to other land uses; accessibility is a critical component in determining the costs and rewards of any investment. The study is being conducted to investigate the impact of accessibility on the rental values of retail premises. The purpose of this study was to determine the extent to which accessibility affects the rental value of retail premises. The following goals were established: to assess the rent in various locations inside the market from the primary major route. The stratified random sample approach was employed to acquire the data to evaluate if there is a variance in rent and the link between rental value and distance. Data were examined using descriptive statistics and linear regression using SPSS. The data indicated that rent varies within the market as distance increases. It was found that as distance increases to the market, the rental prices of store premises fall, and there is a strong positive linear relationship between distance and rental value. The report also advised that the government establish market parking space. The government should also give private shop property investors appropriate loans at cheap interest rates to boost investment in this sector.

In the blind spot: ethnic retailing in Helsinki and the spontaneous placemaking of abandoned spaces

ABSTRACT Currently, hypermarkets represent most of the Finnish retail property stock leading to the dwindling of small mainstream retail. Accordingly, many retail premises have been left vacant at the old shopping centres in suburbia. Ethnic retailing has remarkably impacted the urban landscape of the city of Helsinki and spontaneously converted such abundant premises into livable agglomerations, which has contributed to placemaking. The aim of this paper is to study ethnic retailing through two case studies in Helsinki, with an explicit focus on its role in placemaking and the response of urban planning to the phenomenon. The case studies do not report success in planning for diversity. On the contrary, urban renewal policy threatens the existence of two successful agglomerations. The contribution of this paper is threefold. First, it demonstrates that ethnic retailing has a structured capacity to deal with market impacts, and the clustering of intercultural entrepreneurship supports its success. Second, the empirical work showed that factors related to space and its usage are already discussed in the theoretical work on placemaking. Third, it argues that the rigid boundaries of planning have prevented the city from perceiving the potential of ethnic retailing and placemaking remains in a blind spot.

Association of Infrastructure and Route Environment Factors with Cycling Injury Risk at Intersection and Non-Intersection Locations: A Case-Crossover Study of Britain.

Objective: This paper examines infrastructural and route environment correlates of cycling injury risk in Britain for commuters riding in the morning peak. Methods: The study uses a case-crossover design which controls for exposure. Control sites from modelled cyclist routes (matched on intersection status) were compared with sites where cyclists were injured. Conditional logistic regression for matched case–control groups was used to compare characteristics of control and injury sites. Results: High streets (defined by clustering of retail premises) raised injury odds by 32%. Main (Class A or primary) roads were riskier than other road types, with injury odds twice that for residential roads. Wider roads, and those with lower gradients increased injury odds. Guard railing raised injury odds by 18%, and petrol stations or car parks by 43%. Bus lanes raised injury odds by 84%. As in other studies, there was a ‘safety in numbers’ effect from more cyclists. Contrary to other analysis, including two recent studies in London, we did not find a protective effect from cycle infrastructure and the presence of painted cycle lanes raised injury odds by 54%. At intersections, both standard and mini roundabouts were associated with injury odds several times higher than other intersections. Presence of traffic signals, with or without an Advanced Stop Line (‘bike box’), had no impact on injury odds. For a cyclist on a main road, intersections with minor roads were riskier than intersections with other main roads. Conclusions: Typical cycling environments in Britain put cyclists at risk, and infrastructure must be improved, particularly on busy main roads, high streets, and bus routes.

Attribute accessibility, normative influence, and the effect of classical and country music on willingness to pay for social identity and utilitarian products

Previous studies indicate that background classical music is associated with customers in retail and leisure premises being prepared to pay more for various products and services. This online experiment tests whether these effects are due to music increasing the salience of valued product attributes (attribute accessibility hypothesis) or to a demand characteristic wherein music implies a norm to purchase expensive items (normative behavior hypothesis). A 3 (type of music—classical, country, no music, between subjects) × 2 (type of product—social identity or utilitarian, within subjects) × 2 (high vs. low incentive for accuracy, between subjects) mixed design was used in which participants stated the specific amount they would be prepared to pay for 30 products using free-choice format. Results showed a Music × Type of Product interaction, such that preparedness to spend was higher in the classical music condition but only in the case of social identity products. This is more consistent with the attribute accessibility hypothesis than the normative behavior hypothesis, and various commercial and practical consequences of these findings are discussed.

Use of a supply ventilation system as an air curtain

Recently, for a number of reasons, retail and office premises on the first floors of the building, which have a separate entrance to the street, have gained wide popularity. These rooms must have supply ventilation to maintain the required microclimate parameters. The article proposes, in addition to fulfilling its main function, to use general exchange ventilation as an air curtain in these types of premises. Due to the supply of air above the doorway with certain parameters, in some cases, it is possible to abandon the thermal air curtain as a separate energy-intensive device. The implementation of this task is supposed to be carried out by organizing the necessary air exchange scheme, without increasing its required performance. The article presents the results of the study, which make it possible to assess the possibility of using the proposed technical solution for the most standard case. In particular, an adapted calculation of the air distribution grille is presented to fulfill the stated purpose.

Occurrence of Listeria and Escherichia coli in frozen fruit and vegetables collected from retail and catering premises in England 2018–2019

Frozen vegetables have previously been associated with outbreaks of listeriosis in both the USA and Europe. An outbreak of Listeria monocytogenes serogroup 4 caused 53 cases in five European countries between 2015 and 2018. Whole genome sequencing (WGS) indicated that frozen sweet corn from a producer in Hungary was the source of illness. However, limited data is available on the prevalence of Listeria in frozen produce. A study of frozen fruit and vegetables from catering and retail premises in England was therefore carried out to assess their microbiological quality with respect to Listeria and Escherichia coli.Between December 2018 and April 2019, 1050 frozen fruit and vegetable samples were collected. Of these, 99% were of a satisfactory or borderline microbiological quality. Eleven samples (1%) contained ≥100 cfu/g of Escherichia coli (considered unsatisfactory in products labelled as ready-to-eat). Listeria monocytogenes or other Listeria species were detected in six samples (2%) of fruit compared to 167 samples (24%) of vegetables and six samples (26%) of fruit and vegetable mixes, but none at a level of ≥100 cfu/g. Characterisation by WGS of 74 L. monocytogenes isolates identified ten genetic clusters indicating a common source. For 8 of the 10 clusters, the isolates came from homogenous food types: four were sweet corn, and there was one cluster each for beans, peas, peppers and broccoli. There were five genetic associations between isolates from frozen vegetables and from clinical cases of listeriosis, including two cultures from frozen beans that were indistinguishable from the 2015–2018 sweet corn outbreak strain.This study indicates that L. monocytogenes was present in 10% of frozen vegetables and even though products are generally not ready-to-eat and are intended to be cooked prior to consumption, these have the potential to cause illness. Clear cooking and handling instructions are therefore required on these products to ensure that the health of consumers is not put at risk, and appropriate Good Manufacturing Practice measures should be followed by all fruit and vegetable freezing plants in order to reduce contamination with Listeria during processing.

Analysis of demand for commercial real estate of the Moscow Region

The commercial real estate market is a specific and rapidly changing subject for research. Commercial real estate market is connected with the real sector of the economy through consumer demand, and it is connected with the financial market through alternative investment returns. Therefore, this market is actively studied by the Russian and foreign researchers. The most poorly studied issue in this market is its demand side. But the analysis of demand is difficult due to the fact that the buying cycle in the market is very long, and potential buyers are not registered anywhere until the transaction is completed. But the execution of the transaction is not a reflection of demand, as it is the result of negotiations between the seller and the buyer, which may not succeed, as the potential buyer can choose an alternative way of owning property (rent, sublease, co-working) or generating income (bonds, stocks, shares). In this paper, we analyze the demand for commercial real estate in the Moscow region, compare supply and demand in this market, and present a study of the demand for retail, office and industrial-warehouse real estate. We propose a model for pricing commercial real estate. We found a significant discrepancy between supply and demand in the market according in line with their structure, inequality of demand for retail, office and industrial-warehouse premises, the dependence of the price per square meter of real estate to its area (in square footage) and location. The results obtained are consistent with Russian and foreign studies on the analysis of the commercial real estate market. The results of the study may be useful to such players in the commercial real estate market as developers, investors, buyers.

Fate of Listeria monocytogenes in the Presence of Resident Cheese Microbiota on Common Packaging Materials.

Literature data regarding the survival of microorganisms on materials used for food package purposes are scarce. The aim of the current study is to assess the survival of Listeria monocytogenes on different packaging materials for dairy products during extended storage at different temperatures. Three packaging materials (5 × 5 cm) were contaminated with a cocktail of five strains of Listeria monocytogenes suspended in a cheese homogenate, including the cheese’s native microbial population. Contaminated samples were incubated at 37°, 12°, and 4°C and periodically analyzed up to 56 days. The evolution of the total viable count and pathogen population was evaluated. At 37°C, the results showed that Listeria monocytogenes was no longer detected on polyethylene-coated nylon (B) by day 4 and on polyethylene-coated parchment (A) and greaseproof paper (C) by day 7. Interestingly, the initial cell population (ranging between 2.5 and 2.7 log CFU/cm2) of Listeria monocytogenes increased to 3 log CFU/cm2 within 4 days of storage at 12°C on A and C. During storage, the number remained fairly constant at 12°C and 4°C on two materials (A–C) and decreased slowly on the third one (B). This study shows that survival of Listeria monocytogenes on packaging materials for dairy products will be higher when stored at 4 or 12°C compared to 37°C. The survival of Listeria monocytogenes on the packaging materials raises concerns of cross-contamination during food handling and preparation at catering and retail premises and within the home, highlighting the importance of treating the packaging materials as a potential source of cross-contamination. These initial findings may aid in quantifying risks associated with contamination of food packaging materials.

Microbial Quality and Safety of Sushi Prepared with Gloved or Bare Hands: Food Handlers' Impact on Retail Food Hygiene and Safety

Food handlers play an important role in retail food hygiene and safety. This study was conducted to better understand the impact of food handlers on the microbiological quality and safety of sushi and ingredients handled by gloved and bare hands. At retail premises, food handlers were asked to prepare a batch of sushi with raw fish followed by a batch of sushi with cooked ingredients. Food (sushi and ready-to-eat ingredients), hand, and glove samples were collected for analysis of overall microorganisms (standard plate counts) and targeted foodborne bacteria: Staphylococcus aureus, Bacillus cereus, Escherichia coli, Salmonella, and Listeria monocytogenes. Results suggested that cross-contamination was more prevalent at premises where bare hands were used to prepare sushi. When bare hands were used, significantly higher standard plate counts were obtained from samples of cooked rice (2.3 to 4.9 log CFU/g) and sushi (2.8 to 6.9 log CFU/g) and the prevalence of S. aureus in samples was higher on food (21.7%, 28 of 129 samples) and hands (30%, 18 of 60 samples) ( P < 0.05). Glove changing in combination with hand washing minimized cross-contamination during sushi preparation as indicated by the lower prevalence of S. aureus (0%, 0 of 28 samples) and total targeted foodborne bacteria (3.6%, 1 of 28 samples) on the gloves of food handlers who changed gloves and washed their hands compared with those handlers who did not don new gloves. Repeated use of dishcloths could be a cause of cross-contamination, and the prevalence of total targeted foodborne bacteria was significantly higher on hands dried with dishcloths (64.7%, 11 of 17 samples) than on hands dried with paper towels (12.5%, 1 of 8 samples) ( P < 0.05). The prevalences of B. cereus, L. monocytogenes, and Salmonella in the 356 food samples were 5.1% (18 samples), 0.8% (3 samples), and 0%, respectively. Improvements to hand washing, hand drying, and glove changing practices are needed to lower the occurrence of cross-contamination during sushi preparation.

Editorial and News

Editorial and News

Increasing powers to reject licences to sell alcohol: Impacts on availability, sales and behavioural outcomes from a novel natural experiment evaluation

Excessive alcohol consumption leads to negative health and social impacts at individual and population levels. Interventions that aim to limit the density of alcohol retail premises (including cumulative impact policies (CIPs)) have been associated with decreases in alcohol-related crime and alcohol-related hospital admissions. We evaluated the quantitative impact of introducing a new alcohol licensing policy that included a comprehensive Cumulative Impact Policy (CIP) enforced in seven Cumulative Impact Zones (CIZs) in one English Local Authority in 2013. We used time series analysis to assess immediate and longer term impacts on licensing decisions and intermediate outcomes, including spatial and temporal alcohol availability, crime, alcohol-related ambulance call-outs and on-licence alcohol retail sales across the Local Authority and in CIZs and non-CIZs during the period 2008 to 2016. We found no impact on licence application rates but post-intervention applications involved fewer trading hours. Application approvals declined initially but not over the longer term. Longer term, small reductions in units of alcohol sold in bars (−2060, 95% confidence interval (CI) = −3033, −1087) were observed in areas with more intensive licensing policies (‘Cumulative Impact Zones’ (CIZs)). Significant initial declines in overall crime rates (CIZs = −12.2%, 95% CI = −18.0%, −6.1%; non-CIZs = −8.0%, 95% CI = −14.0%, −1.6%) were only partially reversed by small, longer term increases. Ambulance callout rates did not change significantly. The intervention was partially successful but a more intensive and sustained implementation may be necessary for longer term benefits.

Whole-of-community interventions to reduce population-level harms arising from alcohol and other drug use: a systematic review and meta-analysis.

Whole-of-community interventions aim to reduce alcohol and other drug (AOD) use and harms by mobilizing community leaders, organizations and policy-makers to respond effectively to AOD use. The aim of this review is to estimate the effectiveness of whole-of-community interventions in reducing population-level harms arising from AOD use. A systematic review of electronic databases CENTRAL, Embase, Medline, Medline in Process and PsycINFO was conducted from database inception to August 2017. Eligible trials had a parallel comparison group, implemented interventions in two or more community settings, and reported data on AOD use or harms. Intervention settings included schools, sporting clubs, police and law enforcement agencies, community centres, local media and retail premises. Twenty-four trials from 63 publications were included (n=249 125 participants). Outcomes from AOD consumption (quantity and frequency), AOD-related crime and AOD-related accidents, injuries and hospital admissions. Data were pooled using random-effects inverse variance meta-analysis in Review Manager version 5.3. Risk of bias was mostly high, due to lack of random allocation, selective reporting and significant attrition. Meta-analyses indicated significant reductions in risky drinking [Alcohol Use Disorders Identification Scale (AUDIT) >8; three trials (7 data points), relative risk (RR)=0.78, 95% confidence interval (CI)=0.62-0.99)], but found no impact on past-month alcohol use (five trials, RR=0.95, 95% CI=0.89-1.02), binge drinking (five trials, RR=0.97, 95% CI=0.89-1.06) or 12-month marijuana use (two trials, RR=0.98, 95% CI=0.86-1.11). Narrative synthesis indicated some reductions in AOD-related assault rates and arrests, but were equivocal for quantity of alcohol consumed, 12-month illicit drug use, assault or abuse, motor vehicle accidents and hospital admissions. Interventions to reduce alcohol and other drug use and harms applied to whole communities have resulted so far in small reductions in risky alcohol consumption, but have had little impact upon past month alcohol use, binge drinking or 12-month marijuana use and the studies have been subject to high risk of bias.

Getting the balance right-tackling the obesogenic environment by reducing unhealthy options in a hospital shop without affecting profit.

UK hospitals have been criticized for fuelling obesity by allowing contracts with food retailers selling high fat and high-sugar products on hospital premises. We assessed the impact for a major retailer of increasing healthy food choices at their Royal Free London NHS Foundation Trust outlet. To assess the impact on sales, profit and acceptability to customers, a multi-component intervention based on behavioural insights theory was enacted over 2 months (November-December 2014) at the Royal Free site WHSmith. Sales data on all food and drink were assessed over three time periods: (i) 2 months immediately prior to, and (ii) immediately after the intervention, and (iii) the equivalent period 10 months later. Acceptability to customers was assessed via questionnaires, and profit assessed as a proxy for retailer satisfaction. Compared to the pre-intervention period, total sales increased immediately after the intervention, and again 10 months after the intervention. Sales of healthier options increased as a proportion of total sales following the intervention, sales of sweets and chocolates decreased, while the relative sales of other items remained similar. We demonstrated that healthier alternatives could be provided in a hospital retail premises without negatively affecting total sales, retailer or customer satisfaction.