Howard, Steven J.; Gordon, Ross; Jones, Sandra C
Background Despite a complex and multi-faceted alcohol policy environment in Australia, there are few comprehensive reviews of national and state alcohol policies that assess their effectiveness and research support. In mapping the Australian alcohol policy domain and evaluating policy interventions in each of the core policy areas, this article provides a useful resource for researchers. The implications for protecting public health emanating from this mapping and evaluation of alcohol polic...
Schmied, Virginia; Donovan, Jenny; Kruske, Sue; Kemp, Lynn; Homer, Caroline; Fowler, Cathrine
Nurses and midwives play a key role in providing universal maternal, child and family health services in Australia. However, the Australian federation of states and territories has resulted in policy frameworks that differ across jurisdictions and services that are fragmented across disciplines and sectors. This paper reports the findings of a study that reviewed and synthesised current Australian service policy or frameworks for maternity and child health services in order to identify the degree of commonality across jurisdictions and the compatibility with international research on child development. Key maternity and child health service policy documents in each jurisdiction were sourced. The findings indicate that current policies were in line with international research and policy directions, emphasising prevention and early intervention, continuity of care, collaboration and integrated services. The congruence of policies suggests the time is right to consider the introduction of a national approach to universal maternal, child health services. PMID:22545909
Smith, Jennifer L.; Mitchell, Paul; Wang, Jie Jin; Leeder, Stephen R
Background As in all western countries, Australia's older population experiences high levels of hearing impairment coupled with relatively low levels of hearing device usage. Poor hearing diminishes the quality of life of affected individuals and their families. This paper discusses how to improve Australian hearing health policies in order to better combat this impairment amongst older Australians. Method We searched the databases Medline, Meditext and Web of Science to find articles that di...
Correa-Velez, Ignacio; Gifford, Sandra M; Bice, Sara J
Since the tightening of Australian policy for protection visa applicants began in the 1990s, access to health care has been increasingly restricted to asylum seekers on a range of different visa types. This paper summarises those legislative changes and discusses their implications for health policy relating to refugees and asylum seekers in Australia. Of particular concern are asylum seekers on Bridging Visas with no work rights and no access to Medicare. The paper examines several key quest...
Faunce, Thomas A; Townsend, Ruth
Four formal rounds of Trans-Pacific Partnership Agreement (TPPA) negotiations took place in 2010. They involved over 200 officials from Australia, the United States, New Zealand, Chile, Singapore, Brunei, Peru, Vietnam and Malaysia. Future negotiations officially are set to include three issues with public health and medicines policy implications for Australia and our region: ways to approach regulatory coherence and transparency; how to benefit multinational and small-medium enterprises; and multilateral investor-state dispute settlement. US-based multinational pharmaceutical companies are lobbying for TPPA provisions like those in the Australia-US Free Trade Agreement, which reduce government cost-effectiveness regulatory control of pharmaceuticals, threatening equitable access to medicines. They also advocate increased TPPA intellectual monopoly privilege protection, which will further limit the development of Australian generic medicine enterprises and restrict patient access to cheap, bioequivalent prescription drugs. Of particular concern is that proposed TPPA multilateral investor-state dispute settlement procedures would allow US corporations (as well as those of other TPPA nations) to obtain damages against Australian governments through international arbitral proceedings if their investments are impeded by Australian public health and environment protection legislation. PMID:21241222
Gray Jamieson, Gwendolyn
The women’s health movement shocked and scandalised when it burst into Australian politics in the early 1970s. It cast the light of day onto taboo subjects such as sexual assault, abortion and domestic violence, provoking outrage and condemnation. Some of the services women created for themselves were subjected to police raids; sex education material was branded ‘indecent’. Moreover, women dared to criticise revered institutions, such as the medical system. Yet for all its perceived radicalis...
Full Text Available BACKGROUND: The Australian Private Health Insurance Incentive (PHII policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA. METHODS AND FINDINGS: All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the PHII introduction were estimated and compared with expected rates had the reforms not occurred. Rate and percentage differences (including 95% confidence intervals were estimated separately for public and private patients, by mode of delivery, and by length of stay in hospital following birth. The PHII policy introduction was associated with a 20% (-21.4 to -19.3 decrease in public birth rates, a 51% (45.1 to 56.4 increase in private birth rates, a 5% (-5.3 to -5.1 and 8% (-8.9 to -7.9 decrease in unassisted and assisted vaginal deliveries respectively, a 5% (-5.3 to -5.1 increase in caesarean sections with labour and 10% (8.0 to 11.7 increase in caesarean sections without labour. Similarly, birth rates where the infant stayed 0-3 days in hospital following birth decreased by 20% (-21.5 to -18.5, but rates of births with >3 days in hospital increased by 15% (12.2 to 17.1. CONCLUSIONS: Following the PHII policy implementation in Australia, births in privately insured patients, caesarean deliveries and births with longer infant hospital stays increased. The reforms may not have been beneficial for quality obstetric care in Australia or the burden of Australian hospitals.
Phillips, Clare; Fisher, Matt; Baum, Fran; MacDougall, Colin; Newman, Lareen; McDermott, Dennis
Background There is a significant body of evidence that highlights the importance of addressing the social determinants of child and youth health. In order to tackle health inequities Australian governments are being called upon to take action in this area at a policy level. Recent research suggests that the health and well-being of children and youth in Australia is ‘middle of the road’ when compared to other OECD countries. To date, there have been no systematic analyses of Australian child...
Mulholland Kim; Allotey Pascale; Johnston Vanessa; Markovic Milica
Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sect...
Zardo, Pauline; Collie, Alex; Livingstone, Charles
This study examined external factors affecting policy and program decision-making in a specific public health policy context: injury prevention and rehabilitation compensation in the Australian state of Victoria. The aim was twofold: identify external factors that affect policy and program decision-making in this specific context; use this evidence to inform targeting of interventions aimed at increasing research use in this context. Qualitative interviews were undertaken from June 2011 to January 2012 with 33 employees from two state government agencies. Key factors identified were stakeholder feedback and action, government and ministerial input, legal feedback and action, injured persons and the media. The identified external factors were able to significantly influence policy and program decision-making processes: acting as both barriers and facilitators, depending on the particular issue at hand. The factors with the most influence were the Minister and government, lawyers, and agency stakeholders, particularly health providers, trade unions and employer groups. This research revealed that interventions aimed at increasing use of research in this context must target and harness the influence of these groups. This research provides critical insights for researchers seeking to design interventions to increase use of research in policy environments and influence decision-making in Victorian injury prevention and rehabilitation compensation. PMID:24632115
This article identifies significant historical and contemporary issues, programs, and progress to better understand the current policy in Australia relating to Aboriginal child health and well-being. A legislative perspective gives context to contemporary issues based on legally sanctioned historical practices specifically designed to make Aboriginal peoples disappear, particularly through the control and assimilation of Indigenous children. PMID:19962036
Full Text Available Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sectional survey was conducted with 71 Iraqi Temporary Protection Visa (TPV refugees and 60 Iraqi Permanent Humanitarian Visa (PHV refugees, residing in Melbourne, Australia. Prior to a recent policy amendment, TPV refugees were only given temporary residency status and had restricted access to a range of government funded benefits and services that permanent refugees are automatically entitled to. The quantitative results were triangulated with semi-structured interviews with TPV refugees and service providers. The main outcome measures were self-reported physical and psychological health. Standardised self-report instruments, validated in an Arabic population, were used to measure health and wellbeing outcomes. Results Forty-six percent of TPV refugees compared with 25% of PHV refugees reported symptoms consistent with a diagnosis of clinical depression (p = 0.003. After controlling for the effects of age, gender and marital status, TPV status made a statistically significant contribution to psychological distress (B = 0.5, 95% CI 0.3 to 0.71, p ≤ 0.001 amongst Iraqi refugees. Qualitative data revealed that TPV refugees generally felt socially isolated and lacking in control over their life circumstances, because of their experiences in detention and on a temporary visa. This sense of powerlessness and, for some, an implicit awareness they were being denied basic human rights, culminated in a strong sense of injustice. Conclusion Government asylum policies
Hurley, John; Hutchinson, Marie; Bradbury, Joanne; Browne, Graeme
Public sector organizations have been shown to have high levels of workplace bullying, despite widespread adoption of zero-tolerance policy. Given the level of harm that stems from bullying, it has been suggested that it might be one of the most serious problems facing modern organizations. The qualitative findings from a large cross sectional study of public servants in Australia are reported in the present study. The results highlight palpable mental distress and illness stemming from exposure to workplace bullying. This distress was exacerbated by failures in prohibitive workplace procedures. Reporting bullying through formal organization processes did not lead to resolution of the problem; it instead highlighted feelings of powerlessness and mistrust. In light of the findings, we suggest that an alternative discourse is required, one that gives attention to enhancing employee resilience and self-healing behaviours to the emotional trauma of workplaces. Organizations might be better placed investing resources in fostering the resilience and emotional intelligence of their workforce, rather than continuing to invest resources in prohibitive policies that fail to address the problem. Employees should be supported to prioritize responsibility for their own mental health, rather than an overreliance on organizational responses. PMID:26752457
The discussion traces the evolution of Australian migration policy since 1975, arguing that the primary factor shaping policy has been interparty competition for influence within Australia's ethnic communities. Since late 1975 when the Liberal/National Country Party (LibNCP) Conservative Government returned to power, Australian immigration policy has moved in different directions from the previous post World War II experience. The demographic implications have been profound. In 1975 the LibNCP government returned to office committed to restoring an active migration program. By 1980-81 it had largely succeeded in this numerical goal. Australia's migration growth rate at .82% of the total population exceeded almost all other Western society. What was new, in comparison to previous policy, was the migrant selection system and source countries. By the time the government lost office in March 1983, family reunion had become the major migration program souce and Asia was rapidly becoming the dominant place of migrant origin. This emphasis on family reunion was not intended by government immigration planners but was a product of domestic political change and resultant new influences over migration policy. As to the increasing Asian component, it has mainly been an unintended consequence of the expansion in the family reunion program. Although the liberalization of family reunion eligibility has largely been designed to appease the major Southern European ethnic communities, few applications have been forthcoming from these countries. Asian applicants have been numerous. Labor government policy since March 1983 has shown remarkable continuity with that of the LibNCP both in its selection system and in the size of the migrant intake. The motivation for the commitment to immigration derived first from longstanding traditions within the Australian business community that Australia's economic growth and dynamism depended on rapid population growth. More specifically there
Melissa J. Stoneham; Jodie Goodman; Mike Daube
It is acknowledged that health outcomes for Australian Indigenous peoples are lower than those of non-Indigenous Australians. Research suggests negative media in relation to Indigenous Australians perpetuates racist stereotypes among the wider population and impacts on the health of Indigenous Australians. This study examined the media portrayal of Indigenous Australian public health issues in selected media over a twelve month period and found that, overwhelmingly, the articles were negative...
Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations. PMID:22257324
Jones, Tiffany; Gray, Emily; Harris, Anne
Recognition of human rights on the basis of sexual orientation, gender identity and intersex status by the United Nations has led to the development of new policies concerning homophobia and transphobia in educational contexts. This paper examines new Australian education policies impacting gay, lesbian, bisexual, transgender, intersex and queer…
Productivity Commission Melbourne Institute of Applied Economic; Social Research
Proceedings of a conference organised by the Productivity Commission and the Melbourne Institute of Economic and Social Research held on 7-8 March 2002 to explore key policy issues facing Australia's health sector. The Roundtable drew together thirty leading practitioners and analysts on health policy issues. The topics covered included international developments in health policy, cost pressures in health care systems, access and service delivery, supplier-induced demand and occupational regu...
There are intersections that can occur between the respective peak Australian school education policy agendas. These policies include the use of technologies in classrooms to improve teaching and learning as promoted through the Melbourne Declaration on Educational Goals for Young Australians and the Australian Curriculum; and the implementation of professional standards as outlined in the Australian Professional Standard for Principals and the Australian Professional Standards for Teachers. ...
Australian governments have recently moved from cash accounting to accrual accounting. In doing so they have made simultaneous use of two rival accrual accounting frameworks: AAS 31 and GFS. AAS 31 and GFS operating result measures differ significantly. To date, the AAS 31 framework has enjoyed primacy. This paper evaluates these two frameworks, and suggests that GFS is superior. Accrual accounting has been accompanied at the national government level by the introduction of a new key fiscal p...
Policy implementation at school level is often recognised as transformative enactment. Positioning school leaders as gatekeepers in this enactment is limiting. This study of one Australian school explores the complex contextualised agency of school leaders showing that their role, far more than gatekeeping, can be enabling and transformative.…
Wilson, Katie; Wilks, Judith
The growth of Aboriginal and Torres Strait Islander participation in Australian higher education from 1959 to the present is notable statistically, but below population parity. Distinct patterns in government policy-making and programme development, inconsistent funding and political influences, together with Indigenous representation during the…
The subject is discussed as follows: general introduction; formulation of uranium policy (the public debate; the Ranger Enquiry into all environmental aspects of a proposal by the AAEC and Ranger Uranium Mines to develop certain uranium deposits in the Northern Territory of Australia; the Government's decision); issues (non-proliferation and uranium safeguards policy; uranium enrichment in Australia; government involvement in uranium development; U development and environmental protection; U development and the Australian aborigines); conclusions. (U.K.)
Bellew, Bill; Schöeppe, Stephanie; Bull, Fiona C; Bauman, Adrian
Background This paper provides an historical review of physical activity policy development in Australia for a period spanning a decade since the release of the US Surgeon General's Report on Physical Activity and Health in 1996 and including the 2004 WHO Global Strategy on Diet, Physical Activity and Health. Using our definition of 'HARDWIRED' policy criteria, this Australian review is compared with an international perspective of countries with established national physical activity policie...
Melissa J. Stoneham
Full Text Available It is acknowledged that health outcomes for Australian Indigenous peoples are lower than those of non-Indigenous Australians. Research suggests negative media in relation to Indigenous Australians perpetuates racist stereotypes among the wider population and impacts on the health of Indigenous Australians. This study examined the media portrayal of Indigenous Australian public health issues in selected media over a twelve month period and found that, overwhelmingly, the articles were negative in their portrayal of Indigenous health. A total of 74 percent of the coverage of Australian Indigenous related articles were negative, 15 percent were positive, and 11 percent were neutral. The most common negative subject descriptors related to alcohol, child abuse, petrol sniffing, violence, suicide, deaths in custody, and crime.
Brennan, Donna C.
The environmental consequences of shrimp farming in Asia have caused widespread public concern. One of the main environmental impacts is the high nutrient load that is discharged from ponds, as part of the management routine aimed at maintaining pond water quality. In Australia, where there is a high level of community awareness of the problems associated with eutrophication, the Environmental Protection Agencies are faced with the difficult task of determining effluent control policies for t...
Australia's energy system faces a number of environmental challenges and chief among them is reducing greenhouse gas emissions. In the electricity sector, the Australian government has began implementing policies, which require greater use of gas and renewables based technologies. In this study, we simulate the optimal shares of several electricity generation technologies for Australia under a policy of greenhouse gas mitigation. In doing so, we seek to determine the likely technological investment paths over the next two decades and consider the sensitivity of those projections to assumptions regarding technological change, resource scarcity and economies or diseconomies of scale
... Resources About Us Federal Office of Rural Health Policy News $16 million in funding to improve health ... and learn more about FORHP programs. Rural Health Policy FORHP prepares regular policy announcements focusing on the ...
Renewable electricity is pivotal to the medium and long-term reduction of Australia's greenhouse gas (GHG) emissions, if deep cuts in them are eventually implemented. This paper examines the effectiveness of the principal existing policies that could potentially promote the expansion of renewable electricity (RElec) in Australia: the expanded Renewable Energy Target (RET); the proposed emissions trading scheme (ETS); and the state and territory-based feed-in tariffs. We find the effectiveness of RET is severely eroded by the inclusion of solar and heat pump hot water systems; by the inclusion of 'phantom' tradable certificates; and by high electricity consumption growth. We also find that the ETS will not produce a high enough carbon price to assist most RElec technologies before 2020; and that most of the feed-in tariffs exclude large-scale RElec and will give little assistance to small-scale RElec because they are mostly net tariffs. Unless there is a major revision of its RElec policy mechanisms, Australia will fail to reach its renewable electricity target and in particular will fail to build up its solar generation capacity which could be a major source of future deep cuts in the country's electricity generation emissions. (author)
Renewable electricity is pivotal to the medium and long-term reduction of Australia's greenhouse gas (GHG) emissions, if deep cuts in them are eventually implemented. This paper examines the effectiveness of the principal existing policies that could potentially promote the expansion of renewable electricity (RElec) in Australia: the expanded Renewable Energy Target (RET); the proposed emissions trading scheme (ETS); and the state and territory-based feed-in tariffs. We find the effectiveness of RET is severely eroded by the inclusion of solar and heat pump hot water systems; by the inclusion of 'phantom' tradable certificates; and by high electricity consumption growth. We also find that the ETS will not produce a high enough carbon price to assist most RElec technologies before 2020; and that most of the feed-in tariffs exclude large-scale RElec and will give little assistance to small-scale RElec because they are mostly net tariffs. Unless there is a major revision of its RElec policy mechanisms, Australia will fail to reach its renewable electricity target and in particular will fail to build up its solar generation capacity which could be a major source of future deep cuts in the country's electricity generation emissions.
Hill, Graham L.; Mageean, Pauline
Intended to help administrators, curriculum developers, and teachers integrate occupational health and safety into Australian vocational courses on bricklaying, metal fabrication, and horticulture, this document suggests specific policies and provides further amplification concerning three general policies for that integration. The three general…
Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart
Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470
Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.
Schultz, T. Paul
The program evaluation literature for population and health policies is in flux, with many disciplines documenting biological and behavioral linkages from fetal development to late life mortality, chronic disease, and disability, though their implications for policy remain uncertain. Both macro- and microeconomics seek to understand and incorporate connections between economic development and the demographic transition. The focus here is on research methods, findings, and questions that econo...
Full Text Available Abstract Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health
Full text: The development of climate change policy in Australia is at an important stage in its evolution. Australia, as a ratifying nation of 1992 United Nations Framework Convention on Climate Change, has obligations as a party including development and implementation of national policy. In 2004, Australia announced a Climate Change Strategy updating the 1997 National Greenhouse Strategy which set out the framework for a coordinated and collaborative approach by all levels of government in Australia. The 2004 Climate Change Strategy is directed toward the achievement of three overarching goals: 'international engagement - pursuing an effective global response to climate change', 'emissions management...', and 'providing the foundations for Australia's climate change response...'. Despite not ratifying the Kyoto Protocol, Australia has committed to informally meet its 108% Kyoto Protocol target by taking on the role of an 'as if Party. Development and implementation a broad range of greenhouse gas emission reduction strategies, policies and programs, at the Commonwealth, state and territory, and local government levels, has occurred. Notably, the recent 2007-08 Australian Government Budget brought its total commitment to its climate change strategy to A$2.8 billion. Combined government action and industry investment in climate change mitigation via implementation of greenhouse gas emission reduction schemes are thus well underway. The Commonwealth's programs for greenhouse emission reduction are significant, and in particular, the Greenhouse Challenge Plus program certainly is a key industry motivator. Both state and local government actions have been drivers in policy development, supporting reduction of greenhouse emissions. Several states have implemented their own climate change strategies and the states have been proactive in their interest in emissions trading. Local councils' roles, in particular, have been and will increase in significance in the future
The agencies responsible for tertiary education quality assurance in Australia and New Zealand have established regulatory regimes that increasingly intersect with tertiary institution policy management. An examination of university meta-policies identified good practices guiding university policy and policy management. Most Australian and half of…
Homelessness is a significant social problem worldwide. This paper describes an Australian study that examined print media representations of homelessness and social work, social policy and social work responses to homelessness in three Australian cities. The research included a content analysis of seven Australian newspapers and semi-structured interviews with 39 social workers employed in the field of homelessness in Adelaide, Melbourne and Sydney. The detailed results of these studies have...
Stockwell, Anthony John
Review Article of: Australia and the Formation of Malaysia 1961-1966: Documents on Australian Foreign Policy Edited by MOREEN DEE Canberra, Australian Department of Foreign Affairs and Trade, 2005 xlvi + 654 pp., ISBN 1-920959-22-X; 1-920959-24-6 ($69.05 hardback, $49.95 paperback) By A.J. STOCKWELL
The rising of a new technological era has brought within it opportunities and threats the health systems worldwide have to deal with. In such a changed scenario the role of decision-makers is crucial to identify the real and perceived needs of the population and those areas on intervention in which eHealth can help to improve the quality and efficacy of care. Therefore, in-depth analysis of the state of the art both in industrialized and in developing countries is paramount. Many in fact are constraints that mine the designing and implementation of electronic systems for health. Only if policymakers understand the real implication of eHealth and the complexities of the human being, working model could be introduced. Otherwise the systems proposed will follow the same schemes that have produced failures so far. It implies also that the mutated role of the patient had to be known, together with his expectations and needs. Nevertheless, in a globalize world, a policy for eHealth have to consider also those facto...
Full Text Available There are intersections that can occur between the respective peak Australian school education policy agendas. These policies include the use of technologies in classrooms to improve teaching and learning as promoted through the Melbourne Declaration on Educational Goals for Young Australians and the Australian Curriculum; and the implementation of professional standards as outlined in the Australian Professional Standard for Principals and the Australian Professional Standards for Teachers. These policies create expectations of school leaders to bring about change in classrooms and across their schools, often described as bringing about ‘quality teaching’ and ‘school improvement’. These policies indicate that Australian children should develop ‘democratic values’, and that school principals should exercise ‘democratic values’ in their schools. The national approaches to the implementation of these policies however, is largely silent on promoting learning that fosters democracy through education, or about making connections between teaching and learning with technologies, school leadership and living in a democracy. Yet the policies promote these connections and alignments. Furthermore, understanding democratic values, knowing what is a democracy, and being able to use technologies in democratic ways, has to be learned and practiced. Through the lens of the use of technologies to build digital citizenship and to achieve democratic processes and outcomes in schools, these policy complexities are examined in order to consider some of the implications for school leadership.
Waterworth, Pippa; Dimmock, James; Pescud, Melanie; Braham, Rebecca; Rosenberg, Michael
The factors driving the disparity in health outcomes between Indigenous and non-Indigenous Australians include socio-economic factors, racism, and history. The current study focused on exploring Indigenous participants' perspectives of the factors that affect the health behavior of their community members. Participatory action research methodology and a grounded theory approach were utilized. In total, 120 members of two urban West Australian Indigenous communities participated in focus group discussions. There was substantial similarity between the themes that emerged within the discussions held in the two communities. Factors relating to culture, social connections, racism, communication, and personal aspects were particularly salient to health behavior of the participants. Several of the themes including culture, racism, communication, and distrust highlight the tension caused by being a member of a minority cultural group that has been marginalized by the practices and attitudes of the dominant cultural group. Personal choice was sometimes prioritized over health. PMID:25847855
Murray, Suellen; Powell, Anastasia
The campaign of feminists to have domestic violence formally acknowledged as a key issue affecting Australian women succeeded in the early 1980s when governments began developing policy seeking to address the problem. Far from simply adopting feminist gendered understandings of domestic violence, however, the development of contemporary policy responses to this issue has been influenced by a number of competing discourses about the problem, its causes, and possible solutions. Drawing on Bacchi's policy analysis approach, the authors compare the discursive constructions of domestic violence inherent in how the issue is named, framed, and defined across contemporary Australian policy documents. PMID:19208919
Llewellyn, Gwynnyth; McConnell, David; Gething, Lindsay; Cant, Rosemary; Kendig, Hal
Background: Older parent-carers in Australia are the subject of increasing policy and practice attention due to concerns about their ongoing ability to care in the light of their own ageing and the ageing of their adult son or daughter. This paper examines health status and the coping strategies of a group of older Australian parents caring for an…
Full Text Available Abstract Background Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of ‘White’, Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers’ past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results Racism emerged as a key issue, leading us to more deeply interrogate the role ‘Whiteness’ plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised
Pitman, Tim; Vidovich, Lesley
The Bourdieuian concept of "position-taking" is applied in this analysis of recognition of prior learning (RPL) policy and practice in Australian higher education. Data from institutional documents and participant interviews indicate that, within RPL policy, the universities selectively employ prevailing discourses of "quality" and "equity" to…
Peacock, David; Sellar, Sam; Lingard, Bob
Current national reforms in Australian higher education have prioritised efforts to reduce educational disadvantage within a vernacular expression of neoliberal education policy. Student-equity policy in universities is enmeshed in a set of competitive student recruitment relations. This raises practice-based tensions as universities strive to…
Baum, Fran; Lawless, Angela; Delany, Toni; Macdougall, Colin; Williams, Carmel; Broderick, Danny; Wildgoose, Deborah; Harris, Elizabeth; Mcdermott, Dennis; Kickbusch, Ilona; Popay, Jennie; Marmot, Michael
This article describes some of the crucial theoretical, methodological and practical issues that need to be considered when evaluating Health in All Policies (HiAP) initiatives. The approaches that have been applied to evaluate HiAP in South Australia are drawn upon as case studies, and early findings from this evaluative research are provided. The South Australian evaluation of HiAP is based on a close partnership between researchers and public servants. The article describes the South Australian HiAP research partnership and considers its benefits and drawbacks in terms of the impact on the scope of the research, the types of evidence that can be collected and the implications for knowledge transfer. This partnership evolved from the conduct of process evaluations and is continuing to develop through joint collaboration on an Australian National Health & Medical Research Council grant. The South Australian research is not seeking to establish causality through statistical tests of correlations, but instead by creating a 'burden of evidence' which supports logically coherent chains of relations. These chains emerge through contrasting and comparing findings from many relevant and extant forms of evidence. As such, program logic is being used to attribute policy change to eventual health outcomes. The article presents the preliminary program logic model and describes the early work of applying the program logic approach to HiAP. The article concludes with an assessment of factors that have accounted for HiAP being sustained in South Australia from 2008 to 2013. PMID:25217350
Full Text Available Abstract On 1 January 2005, a controversial trade agreement entered into force between Australia and the United States. Though heralded by the parties as facilitating the removal of barriers to free trade (in ways not achievable in multilateral fora, it also contained many trade-restricting intellectual property provisions and others uniquely related to altering pharmaceutical regulation and public health policy in Australia. The latter appear to have particularly focused on the world-respected process of federal government reimbursement after expert cost-effectiveness evaluation, popularly known as the Pharmaceutical Benefits Scheme ('PBS'. It remains uncertain what sort of impacts – if any – the Australia-United States Free Trade Agreement ('AUSFTA' will have on PBS processes such as reference pricing and their important role in facilitating equitable and affordable access to essential medicines. This is now the field of inquiry for a major three year Australian Research Council ('ARC'-funded study bringing together a team of senior researchers in regulatory theory from the Australian National University and pharmacoeconomics from the University of Newcastle. The project proposes to monitor, assess and analyse the real and potential impacts of the AUSFTA in this area, providing Australian policy-makers with continuing expertise and options. To the extent that the AUSFTA medicines provisions may represent animportant precedent in a global strategy by industry oncost-effectiveness evaluation of pharmaceuticals, the study will also beof great interest to policy makers in other jurisdictions.
Faunce, Thomas; Doran, Evan; Henry, David; Drahos, Peter; Searles, Andrew; Pekarsky, Brita; Neville, Warwick
On 1 January 2005, a controversial trade agreement entered into force between Australia and the United States. Though heralded by the parties as facilitating the removal of barriers to free trade (in ways not achievable in multilateral fora), it also contained many trade-restricting intellectual property provisions and others uniquely related to altering pharmaceutical regulation and public health policy in Australia. The latter appear to have particularly focused on the world-respected process of federal government reimbursement after expert cost-effectiveness evaluation, popularly known as the Pharmaceutical Benefits Scheme ('PBS'). It remains uncertain what sort of impacts--if any--the Australia-United States Free Trade Agreement ('AUSFTA') will have on PBS processes such as reference pricing and their important role in facilitating equitable and affordable access to essential medicines. This is now the field of inquiry for a major three year Australian Research Council ('ARC')-funded study bringing together a team of senior researchers in regulatory theory from the Australian National University and pharmacoeconomics from the University of Newcastle. The project proposes to monitor, assess and analyse the real and potential impacts of the AUSFTA in this area, providing Australian policy-makers with continuing expertise and options. To the extent that the AUSFTA medicines provisions may represent an important precedent in a global strategy by industry on cost-effectiveness evaluation of pharmaceuticals, the study will also be of great interest to policy makers in other jurisdictions. PMID:16209703
Full Text Available This article reports on activities undertaken by Australian universities to support academic staff to provide inclusive teaching. The findings of two lines of inquiry are reported - a desktop audit of the presence of inclusive teaching or universal design for learning (UDL in publically available policies and procedures documents, and a survey of the methods adopted to build staff capacity to provide inclusive teaching and learning. Just over a third (34.21% of Australian universities referred to inclusive teaching or UDL in their policies and procedures. A wide range of current practices in professional development for inclusive teaching was reported, with the most frequent being one-off workshops focussing on accommodating specific groups of students. Improved institutional support through policies, procedures and professional development would enable Australian higher education teachers to provide quality inclusive teaching to all students.
Full Text Available Homelessness is a significant social problem worldwide. This paper describes an Australian study that examined print media representations of homelessness and social work, social policy and social work responses to homelessness in three Australian cities. The research included a content analysis of seven Australian newspapers and semi-structured interviews with 39 social workers employed in the field of homelessness in Adelaide, Melbourne and Sydney. The detailed results of these studies have been published separately elsewhere. This paper reports on how discourses in the print media, social policy and social work practice co-exist in constructing homelessness as a particular social problem, influencing social work responses to homelessness. The research found that individualism is central to many dominant discourses evident in the print media, social policy and social work practice, and that social work is practiced within unequal power relations embedded in organisational contexts.
Veronesi, Gianluca; Harley, Kirsten; Dugdale, Paul; Short, Stephanie D
OBJECTIVE This article provides a policy analysis of the Australian government's National Health Reform Agreement (NHRA) by bringing to the foreground the governance arrangements underpinning the two arms of the national reforms, to primary health care and hospital services. METHODS The article analyses the NHRA document and mandate, and contextualises the changes introduced vis-à-vis the complex characteristics of the Australian health care system. Specifically, it discusses the coherence of the agreement and its underlying objectives, and the consistency and logic of the governance arrangements introduced. RESULTS The policy analysis highlights the rationalisation of the responsibilities between the Commonwealth and states and territories, the commitment towards a funding arrangement based on uniform measures of performance and the troubled emergence of a more decentralised nation-wide homogenisation of governance arrangements, plus efforts to improve transparency, accountability and statutory support to increase the standards of quality of care and safety. CONCLUSIONS It is suggested that the NHRA falls short of adequately supporting integration between primary, secondary and tertiary health care provision and facilitating greater integration in chronic disease management in primary care. Successfully addressing this will unlock further value from the reforms. PMID:24807128
Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how
Coates, Hamish; Krause, Kerri-Lee
This paper reports issues arising from a longitudinal study of 1991 to 2002 Australian higher education equity data. The national equity framework uses an empirical performance indicator system to monitor access, participation, success and retention of six designated equity groups. The paper examines three possible approaches for defining new…
Garrett, Pamela W; Dickson, Hugh G; Whelan, Anna Klinken; Whyte, Linda
Background No recent Australian studies or literature, provide evidence of the extent of coverage of multicultural health issues in Australian healthcare research. A series of systematic literature reviews in three major Australian healthcare journals were undertaken to discover the level, content, coverage and overall quality of research on multicultural health. Australian healthcare journals selected for the study were The Medical Journal of Australia (MJA), The Australian Health Review (AH...
Eliasoph, H; Ronson, J
Clearly, the building blocks are in place for true reform of the healthcare system. Leadership and political fortitude will be needed to direct the reform process and remove existing obstacles. It is the intention of the Policy Group on Health Reform to continue to develop and articulate new thinking and act as a catalyst for implementing solutions, respecting health reform. PMID:10345292
Department of Health
The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here
Hazbo Skoko; Branka Krivokapic-Skoko; Marinko Skare; Arnela Ceric
Many SMEs are currently adopting information and communication technology (ICT) and services based on it. However, there is little systematic research into how they are doing this and what are the organisational and environmental factors associated with this adoption. In this article, the authors build the model of ICT adoption in Australian and Croatian SMEs, founded on premises that SMEs are the main economic developing factor in all modern economies and that the adoption and the use of ICT...
Chalmers, Caitlin; Campbell, Marilyn Anne; Spears, Barbara A; Butler, Des; Cross, Donna; Slee, Phillip; Kift, Sally
Background: Despite decades of research, bullying in all its forms is still a significant problem within schools in Australia, as it is internationally. Anti-bullying policies and guidelines are thought to be one strategy as part of a whole school approach to reduce bullying. However, although Australian schools are required to have these…
Cooke, Penelope R.; Hemmings, Brian C.
The authors of this article report on a qualitative study of Australian community-based natural resource management groups known as Landcare groups. They discuss how four Landcare groups contributed to sustainability practices and how a policy change implemented in 2003 influenced the efforts of the groups to remain active in their activities.…
Written from the perspective of a disability practitioner and equity manager working in the Australian tertiary education sector for over twenty-five years, this paper reviews some of the significant social, equity, and education policy developments and associated legislation, which have influenced the inclusion of people with disabilities in…
Burton, Anthony J.; Hilary J. Bambrick; Friel, Sharon
Background: Within an Australian context, the medium to long-term health impacts of climate change are likely to be wide, varied and amplify many existing disorders and health inequities. How the health system responds to these challenges will be best considered in the context of existing health facilities and services. This paper provides a snapshot of the understanding that Australian health planners have of the potential health impacts of climate change.Methods: The first author interviewe...
Full Text Available Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility
Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D; Helms, David
Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476
Anderson, Heather; Kowal, Emma
The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia. PMID:22881383
Patrick, Rebecca; Kingsley, Jonathan
Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health. PMID:26650394
Kotwal, Sradha; Webster, Angela C; Cass, Alan; Gallagher, Martin
Linked health data bring together data about one person from varying sources such as administrative health datasets, death registries and clinical registries using a process that maintains patient privacy. Linked health data have been used for burden of disease estimates and health-care planning and is being increasingly use as a research methodology to study health service utilisation and patient outcomes. Within Australian nephrology, there has been limited understanding and use of linked health data so far, but we expect that with the increasing availability of data and the growing complexity of health care, the use of such data will expand. This is especially pertinent for the growing elderly population with advanced kidney disease, who are poorly represented in other types of research studies. This article summarizes the history of linked health data in Australia, the nature of available datasets in Australia, the methods of access to these data, privacy and ethical issues, along with strengths, limitations and implications for the future. PMID:26748448
Basedow, Martin; Hibbert,Peter; Hooper,Tamara; Runciman, William; Esterman, Adrian
Martin Basedow,1 Peter Hibbert,1 Tamara Hooper,1 William Runciman,1 Adrian Esterman,2 1School of Psychology, Social Work and Social Policy, 2School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia Objective: The aim of this study was to evaluate the satisfaction of Australian patients who suffer from osteoarthritis (OA) with their health care providers and the perceived helpfulness of treatments and information sources. Methods: A self-administered questionnair...
Steffens, Margie; Jamieson, Lisa; Kapellas, Kostas
Discrimination is a very real facet of Australian Aboriginal and Torres Strait Islander (ATSI) life. Paradies has detailed the strong links between racism and chronic stress and the influence this may have on general health, confounding the pre-supposed notion that ATSI populations are more genetically predisposed to chronic diseases. For example a genetic predisposition promoting central adipose storage in populations with recent (in evolutionary terms) changes to hunter-gatherer dietary patterns is thought to contribute to the higher rates of diabetes seen in ATSI and other Native populations. This relationship, however, is far from causal in any straight-forward way. In support of the work by Paradies, research from the U.S. also shows that racism, both explicit and subtle, contributes to chronic disease and suffering among ethnic minorities. While the exploration of the perceived or self-reported racial discrimination is recent, this concept has increasing evidence to support its relationship to poor health outcomes. PMID:26853197
Emerging infectious diseases arising from livestock and wildlife pose serious threats to global human health, as shown by a series of continuous outbreaks involving highly pathogenic influenza, SARS, Ebola and MERS. The risk of pandemics and bioterrorism threats is ever present and growing, but our ability to combat them is limited by the lack of available vaccines, therapeutics and rapid diagnostics. The use of high bio-containment facilities, such as the CSIRO Australian Animal Health Laboratory, plays a key role studying these dangerous pathogens and facilitates the development of countermeasures. To combat diseases like MERS, we must take a holistic approach that involves the development of early biomarkers of infection, a suite of treatment options (vaccines, anti-viral drugs and antibody therapeutics) and appropriate animal models to test the safety and efficacy of candidate treatments. PMID:27118215
Usher, Kim; Woods, Cindy; Casellac, Evan; Glass, Nel; Wilson, Rhonda; Mayner, Lidia; Jackson, Debra; Brown, Janie; Duffy, Elaine; Mather, Carey; Cummings, Elizabeth; Irwin, Pauletta
Increased bandwidth, broadband network availability and improved functionality have enhanced the accessibility and attractiveness of social media. The use of the Internet by higher education students has markedly increased. Social media are already used widely across the health sector but little is currently known of the use of social media by health profession students in Australia. A cross-sectional study was undertaken to explore health profession students' use of social media and their media preferences for sourcing information. An electronic survey was made available to health profession students at ten participating universities across most Australian states and territories. Respondents were 637 first year students and 451 final year students. The results for first and final year health profession students indicate that online media is the preferred source of information with only 20% of students nominating traditional peer-reviewed journals as a preferred information source. In addition, the results indicate that Facebook usage was high among all students while use of other types of social media such as Twitter remains comparatively low. As health profession students engage regularly with social media, and this use is likely to grow rather than diminish, educational institutions are challenged to consider the use of social media as a validated platform for learning and teaching. PMID:25109207
López-Arellano, O; Blanco-Gil, J
In the last 17 years, health policy in Mexico has been shifted from a conception of integrated health care and a gradually extended coverage as a major responsibility of the State and health care public institutions, to in the one hand, a very active promotion of market and private profit in health services and in the other, poverty relief programs. In this paper we identify different periods corresponding to the last three presidential terms. Each clearly represent different stages of health sector reform: transitional (1982-1988), mercantilisation and poverty relief (1988-1994) and, strengthening of the so called health markets (1994-2000). The analyzed transformation is part of the set of secondary reforms subordinated to the structural adjustment and the economic and social megaprojects imposed by the international financial institutions. PMID:11241926
Manton, Elizabeth; Moore, David
In this article, we draw on recent scholarly work in the poststructuralist analysis of policy to consider how policy itself functions as a key site in the constitution of alcohol 'problems', and the political implications of these problematisations. We do this by examining Australian alcohol policy as it relates to young adults (18-24 years old). Our critical analysis focuses on three national alcohol policies (1990, 2001 and 2006) and two Victorian state alcohol policies (2008 and 2013), which together span a 25-year period. We argue that Australian alcohol policies have conspicuously ignored young adult men, despite their ongoing over-representation in the statistical 'evidence base' on alcohol-related harm, while increasingly problematising alcohol consumption amongst other population subgroups. We also identify the development of a new problem representation in Australian alcohol policy, that of 'intoxication' as the leading cause of alcohol-related harm and rising hospital admissions, and argue that changes in the classification and diagnosis of intoxication may have contributed to its prioritisation and problematisation in alcohol policy at the expense of other forms of harm. Finally, we draw attention to how preliminary and inconclusive research on the purported association between binge drinking and brain development in those under 25 years old has been mobilised prematurely to support calls to increase the legal purchasing age from 18 to 21 years. Our critical analysis of the treatment of these three issues - gender, intoxication, and brain development - is intended to highlight the ways in which policy functions as a key site in the constitution of alcohol 'problems'. PMID:26644026
Full Text Available Many SMEs are currently adopting information and communication technology (ICT and services based on it. However, there is little systematic research into how they are doing this and what are the organisational and environmental factors associated with this adoption. In this article, the authors build the model of ICT adoption in Australian and Croatian SMEs, founded on premises that SMEs are the main economic developing factor in all modern economies and that the adoption and the use of ICT represents the fundamental source of competitiveness and the basis for their survival on the world market. By applying Qualitative Comparative Analysis (QCA and Boolean algebra, the authors developed a model of necessary and sufficient factors for ICT adoption by SMEs in Australia and Croatia.
Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian
Health promotion for Australian Aboriginal and Torres Strait Islander communities and their people has generally had limited efficacy and poor sustainability. It has largely failed to recognise and appreciate the importance of local cultures and continues to have minimal emphasis on capacity......, and their socio-cultural environment, towards better health. This commentary aims to examine and apply the 8 principles of Culturally-Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes its widespread adoption as a framework for a more respectful......, collaborative, locally-acceptable and therefore appropriate approach to Australian Aboriginal and Torres Strait Islander health promotion....
Laws Rachel; King Lesley; Hardy Louise L; Milat Andrew; Rissel Chris; Newson Robyn; Rychetnik Lucie; Bauman Adrian E
Abstract Background There is growing interest by funding bodies and researchers in assessing the impact of research on real world policy and practice. Population health monitoring surveys provide an important source of data on the prevalence and patterns of health problems, but few empirical studies have explored if and how such data is used to influence policy or practice decisions. Here we provide a case study analysis of how the findings from an Australian population monitoring survey seri...
Dale B Truett; Lila J. Truett
This paper investigates factors that have affected the trade balance of the Australian motor vehicle industry and considers the impact of Australian government policies to encourage the development of that industry. It presents an overview of the industry, discusses the history of government policies to promote both manufacturing and exports of motor vehicle products, and provides a comparison of Australia with other developing producers of motor vehicles. A linear regression model is employe...
Background: Australian government policy regards people with intellectual disability (ID) as citizens with equal rights, which means that they should have access to the same opportunities as the wider community. Ageing in place is central to aged care policy in Australia for the general population. Method: This paper reviews policy to support the…
Hewitt, J L
Mental health policy development in the UK has become increasingly dominated by the assumed need to prevent violence and alleviate public concerns about the dangers of the mentally ill living in the community. Risk management has become the expected focus of contemporary mental health services, and responsibility has increasingly been devolved to individual service professionals when systems fail to prevent violence. This paper analyses the development of mental health legislation and its impact on services users and mental health professionals at the micro level of service delivery. Historical precedence, media influence and public opinion are explored, and the reification of risk is questioned in practical and ethical terms. The government's newest proposals for compulsory treatment in the community are discussed in terms of practical efficacy and therapeutic impact. Dangerousness is far from being an objectively observable phenomenon arising from clinical pathology, but is a formulation of what is partially knowable through social analysis and unknowable by virtue of its situation in individual psychic motivation. Risk assessment can therefore never be completely accurate, and the solution of a 'better safe than sorry' approach to mental health policy is ethically and pragmatically flawed. PMID:18307647
Full Text Available IAS 8 defines the concept of accounting policy as "the specific principles, bases, conventions, rules and practices applied by an entity in preparing and presenting financial statements". Within the framework of this concept, this research that is derived from International Financial Reporting Standards (IFRS contributes to the accounting literature by focusing on the alternative accounting policies' debate related to presentation and recognition issues in the European, Australian and Turkish context and concludes that there is an influence of local accounting policies over IFRS practice in Turkey and this influence still exists in Europe and Australia. This shows that as long as diversity in accounting policies of IFRS is present, entities are expected to be inclined to select their local accounting policies by leading to comparability of financial statements within the country rather than between countries in the IFRS context.
Describes the Food and Health Policy Game, an educational board game designed primarily for community health physicians and health education officers, to show how a food and health policy might be implemented to promote healthy diets and preventive medicine by the National Health Service. (MBR)
Full Text Available Tax policy is one of the most important policy in consideration of investment development in certain industry. Research by Newlon (1987, Swenson (1994 and Hines (1996 concluded that tax rate is one of the most important thing considered by investors in a foreign direct investment. One of tax policy could be used to attract foreign direct investment is income tax incentives. The attractiveness of income tax incentives to a foreign direct investment is as much as the attractiveness to a domestic investment (Anwar and Mulyadi, 2012. In this paper, we have conducted a study of income tax incentives in food and agriculture industry; where we conduct a thorough study of income tax incentives and corporate performance in Indonesian and Australian food and agriculture industry. Our research show that there is a significant influence of income tax incentives to corporate performance. Based on our study, we conclude that the significant influence of income tax incentives to Indonesian corporate performance somewhat in a higher degree than the Australian peers. We have also concluded that Indonesian government provide a relatively more interesting income tax incentives compare to Australian government. However, an average method of net income –a method applied in Australia– could be considered by Indonesian government to avoid a market price fluctuation in this industry.
Barnes, Christopher M; Drake, Christopher L
The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders. PMID:26581727
Full Text Available Abstract Background To examine the differences in health services utilisation and the associated risk factors between infants from non-English speaking background (NESB and English speaking background (ESB within Australia. Methods We analysed data from a national representative longitudinal study, the Longitudinal Study of Australian Children (LSAC which started in 2004. We used survey logistic regression coupled with survey multiple linear regression to examine the factors associated with health services utilisation. Results Similar health status was observed between the two groups. In comparison to ESB infants, NESB infants were significantly less likely to use the following health services: maternal and child health centres or help lines (odds ratio [OR] 0.56; 95% confidence intervals [CI], 0.40-0.79; maternal and child health nurse visits (OR 0.68; 95% CI, 0.49-0.95; general practitioners (GPs (OR 0.58; 95% CI, 0.40-0.83; and hospital outpatient clinics (OR 0.54; 95% CI, 0.31-0.93. Multivariate analysis results showed that the disparities could not be fully explained by the socioeconomic status and language barriers. The association between English proficiency and the service utilised was absent once the NESB was taken into account. Maternal characteristics, family size and income, private health insurance and region of residence were the key factors associated with health services utilisation. Conclusions NESB infants accessed significantly less of the four most frequently used health services compared with ESB infants. Maternal characteristics and family socioeconomic status were linked to health services utilisation. The gaps in health services utilisation between NESB and ESB infants with regard to the use of maternal and child health centres or phone help, maternal and child health nurse visits, GPs and paediatricians require appropriate policy attentions and interventions.
This paper examines the sources of Australia's business cycle fluctuations focusing on the role of international shocks and short run stabilization policy. A VAR model identified using robust sign restrictions derived from an estimated structural model is used to aid the investigation. The results indicate that, in contrast to previous VAR studies, foreign factors contribute over half of domestic output forecast errors whereas innovation from output itself has little effect. Furthermore, mone...
Booth, Mark; Hill, Graham; Moore, Michael J; Dalla, Danielle; Moore, Michael G; Messenger, Anne
On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding. The two main objectives of the new PHNs, as stated on the Department of Health's website, are "increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time". Below are three viewpoints, commissioned for this primary health care themed issue of Public Health Research & Practice, from the Australian Government Department of Health, the Public Health Association of Australia and a Sydney-based PHN. We asked the authors to focus particularly on how the newly established networks might help to integrate public health within the primary health care landscape. Our authors have pointed out the huge overlap between public health and primary care and looked at evidence showing the great benefits for health systems of collaboration between the two. Challenges ahead include a possible government focus on delivery of 'frontline' medical services, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, nongovernment organisations, research institutions and local communities. PMID:26863166
In this article I argue for the development of a macro perspective within psychology, akin to that found in macroeconomics. Macropsychology is the application of psychology to factors that influence the settings and conditions of our lives. As policy concerns the strategic allocation of resources—who gets what and why?—it should be an area of particular interest for macropsychology. I review ways in which psychology may make a contribution to policy within the field of global health. Global health emphasizes human rights, equity, social inclusion, and empowerment; psychology has much to contribute to these areas, both at the level of policy and practice. I review the sorts of evidence and other factors that influence policymakers, along with the content, process, and context of policymaking, with a particular focus on the rights of people with disabilities in the low- and middle-income countries of Africa and Asia. These insights are drawn from collaborations with a broad range of practitioners, governments, United Nations agencies, civil society organizations, the private sector and researchers. Humanitarian work psychology is highlighted as an example of a new area of psychology that embraces some of the concerns of macropsychology. The advent of "big data" presents psychology with an opportunity to ask new types of questions, and these should include "understanding up," or how psychological factors can contribute to human well-being, nationally and globally. PMID:25486176
Full Text Available Policy incoherence at the interface between trade policy and health can take many forms, such as international trade commitments that strengthen protection of pharmaceutical patents, or promotion of health tourism that exacerbates the shortage of physicians in rural areas. Focusing on the national policy-making process, we make recommendations regarding five conditions that are necessary, but not sufficient, to ensure that international trade policies are coherent with national health objectives. These conditions are: space for dialogue and joint fact-finding; leadership by ministries of health; institutional mechanisms for coordination; meaningful engagement with stakeholders; and a strong evidence base.
Policy incoherence at the interface between trade policy and health can take many forms, such as international trade commitments that strengthen protection of pharmaceutical patents, or promotion of health tourism that exacerbates the shortage of physicians in rural areas. Focusing on the national policy-making process, we make recommendations regarding five conditions that are necessary, but not sufficient, to ensure that international trade policies are coherent with national health objectives. These conditions are: space for dialogue and joint fact-finding; leadership by ministries of health; institutional mechanisms for coordination; meaningful engagement with stakeholders; and a strong evidence base. PMID:17486206
Laity, Tania; Laffan, Shawn W; González-Orozco, Carlos E; Faith, Daniel P; Rosauer, Dan F; Byrne, Margaret; Miller, Joseph T; Crayn, Darren; Costion, Craig; Moritz, Craig C; Newport, Karl
Phylodiversity measures summarise the phylogenetic diversity patterns of groups of organisms. By using branches of the tree of life, rather than its tips (e.g., species), phylodiversity measures provide important additional information about biodiversity that can improve conservation policy and outcomes. As a biodiverse nation with a strong legislative and policy framework, Australia provides an opportunity to use phylogenetic information to inform conservation decision-making. We explored the application of phylodiversity measures across Australia with a focus on two highly biodiverse regions, the south west of Western Australia (SWWA) and the South East Queensland bioregion (SEQ). We analysed seven diverse groups of organisms spanning five separate phyla on the evolutionary tree of life, the plant genera Acacia and Daviesia, mammals, hylid frogs, myobatrachid frogs, passerine birds, and camaenid land snails. We measured species richness, weighted species endemism (WE) and two phylodiversity measures, phylogenetic diversity (PD) and phylogenetic endemism (PE), as well as their respective complementarity scores (a measure of gains and losses) at 20 km resolution. Higher PD was identified within SEQ for all fauna groups, whereas more PD was found in SWWA for both plant groups. PD and PD complementarity were strongly correlated with species richness and species complementarity for most groups but less so for plants. PD and PE were found to complement traditional species-based measures for all groups studied: PD and PE follow similar spatial patterns to richness and WE, but highlighted different areas that would not be identified by conventional species-based biodiversity analyses alone. The application of phylodiversity measures, particularly the novel weighted complementary measures considered here, in conservation can enhance protection of the evolutionary history that contributes to present day biodiversity values of areas. Phylogenetic measures in conservation
Pinzon-Perez, Helda; Kotkin-Jaszi, Suzanne; Perez, Miguel A.
Health policy has a direct impact on health education initiatives, health care delivery, resource allocation, and quality of life. Increasing rates in the epidemics of obesity and obesity-dependent diabetes mellitus (aka diabesity) suggest that health policy changes should be included in health education and disease prevention strategies. Health…
Robertson Jan A
Full Text Available Abstract Background In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT, extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives in remote Indigenous communities. Methods: With little empirical evidence available, we interviewed 82 key stakeholders across the NT representing operational- and management-level service providers, local Indigenous and non-Indigenous participants to identify challenges and opportunities for translating new policies into successful tobacco interventions. Data were analysed using qualitative approaches to identify emergent themes. Results The 20 emergent themes were classified using counts of occasions each theme occurred in the transcribed data as challenge or opportunity. The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce. 'Smoking cessation support' occurred frequently as opportunity but also frequently as challenge suggesting that support for individuals requires additional input and attention. Conclusions These results from interviews with local and operational-level participants indicate that current tobacco policies in Australia targeting Indigenous smoking are sound and comprehensive
Logan, Helen; Sumsion, Jennifer; Press, Frances
This article considers the value of elite interviews as a frequently overlooked methodology in investigations of policymaking in early childhood education and care (ECEC). We contextualise the discussion within a study that examines constructions of quality in Australian ECEC policymaking between 1972 and 2009. We conclude that, despite their…
Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.
Labonté Ronald; Gagnon Michelle L
Abstract Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation...
This article examines migration policy in Australia with reference to the "White Australia" policy prior to 1975 and the multicultural policy thereafter. Mass immigration has not caused major social tensions. Mass tourism has been welcomed. Australian attitudes have changed from fear of massive numbers of Asians and mass poverty and ignorance to multiculturalism. Suspicious attitudes toward Asians, however, are still present among a minority of Australians. The most influential arguments against Asians are the concerns about employment of new arrivals and the environmental impact of an increasing population. Although there are many cultural differences, Australia is linked to Singapore, Malaysia, and the Philippines in that all have a history of British or American influence. Educated Indians and Sri Lankans are linked to Australians by their common language and Christian religion. The integration of Asians in the business and financial community holds the potential for economic gain over the years. The author finds that the Australian relationship to Asia is more acceptable in public arenas than the comparable changing relationship between Britain and Europe. The roots of a Whites-only policy extend back to 1901, when the Commonwealth Immigration Restriction Act was ratified. The exclusion of non-European immigrants was not specified in the law. The mechanism for exclusion was included in the law. Undesirable immigrants could be excluded. Under mass migration programs after 1947 the population of non-English speaking Europeans increased. By 1973 government shifted from an assimilationist approach to a multicultural approach due to pressure from the Department of Foreign Affairs. Numerous historical events occurring during 1942-80 drew Australia out of its isolationist position in the world. At present about 25% of the total population are of non-British origin. Over 900,000 would have been excluded under the old migration policy. In 1991, 665,315 persons were born
Goldman, Juliette D. G.; Grimbeek, Peter
Background: In the Australian state of Queensland, many Department of Education Policies include behavioural directives for school teachers, whereby "the teacher must..." behave in a certain manner. The introduction of an education policy, such as the mandatory reporting of child sexual abuse by teachers, has significant and wide-ranging…
McCuaig, Louise; Carroll, Kristie; Macdonald, Doune
The teaching of health literacy in school-based health education (SBHE) is of international interest, yet there is less ready access to how conceptions of health literacy can be operationalised in school programmes. More specifically, while articulated in curriculum documents such as the incoming Australian Curriculum: Health and Physical…
Melanie A Wakefield
Full Text Available Objective To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. Methods Data for calculating the average monthly prevalence of smoking between January 2001 and June 2011 were obtained via structured interviews of randomly sampled adults aged 18 years or older from Australia’s five largest capital cities (monthly mean number of adults interviewed: 2375. The influence on smoking prevalence was estimated for increased tobacco taxes; strengthened smoke-free laws; increased monthly population exposure to televised tobacco control mass media campaigns and pharmaceutical company advertising for nicotine replacement therapy (NRT, using gross ratings points; monthly sales of NRT, bupropion and varenicline; and introduction of graphic health warnings on cigarette packs. Autoregressive integrated moving average (ARIMA models were used to examine the influence of these interventions on smoking prevalence. Findings The mean smoking prevalence for the study period was 19.9% (standard deviation: 2.0%, with a drop from 23.6% (in January 2001 to 17.3% (in June 2011. The best-fitting model showed that stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns independently explained 76% of the decrease in smoking prevalence from February 2002 to June 2011. Conclusion Increased tobacco taxation, more comprehensive smoke-free laws and increased investment in mass media campaigns played a substantial role in reducing smoking prevalence among Australian adults between 2001 and 2011.
Coomber, Kerri; Durkin, Sarah J; Scollo, Michelle; Bayly, Megan; Spittal, Matthew J; Simpson, Julie A; Hill, David
Abstract Objective To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. Methods Data for calculating the average monthly prevalence of smoking between January 2001 and June 2011 were obtained via structured interviews of randomly sampled adults aged 18 years or older from Australia’s five largest capital cities (monthly mean number of adults interviewed: 2375). The influence on smoking prevalence was estimated for increased tobacco taxes; strengthened smoke-free laws; increased monthly population exposure to televised tobacco control mass media campaigns and pharmaceutical company advertising for nicotine replacement therapy (NRT), using gross ratings points; monthly sales of NRT, bupropion and varenicline; and introduction of graphic health warnings on cigarette packs. Autoregressive integrated moving average (ARIMA) models were used to examine the influence of these interventions on smoking prevalence. Findings The mean smoking prevalence for the study period was 19.9% (standard deviation: 2.0%), with a drop from 23.6% (in January 2001) to 17.3% (in June 2011). The best-fitting model showed that stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns independently explained 76% of the decrease in smoking prevalence from February 2002 to June 2011. Conclusion Increased tobacco taxation, more comprehensive smoke-free laws and increased investment in mass media campaigns played a substantial role in reducing smoking prevalence among Australian adults between 2001 and 2011. PMID:24940015
A strong biofuel industry in Australia has the potential to provide numerous benefits to the nation and its peoples. The benefits include; reduced emissions of greenhouse gases and harmful particulate matter, a boost to rural development goals, enhanced fuel security and a lower balance of payments. For biofuels to be seriously considered as alternatives to traditional petroleum based automotive fuels they must be economically viable. The findings from a series of Australian Bureau of Agricultural and Resource Economics (ABARE) investigations suggest that ethanol and biodiesel production would be economically viable, in the Australian context, with oil prices in the range of 30-40 USD a barrel. Despite the price of oil being in or above this range for over two years a strong home grown biofuel industry has failed to develop in Australia. The purpose of this master's thesis therefore is to identify the critical issues facing biofuel industry development in Australian and to propose possible policy and private sector strategies for dealing with them. The analysis was done in the following three steps; the first was to map the development of the ethanol and biodiesel industries, the second was to analyse the performance of the industries overtime and the third was to identify the mechanisms which have either induced or blocked their growth. The strategies proposed by this thesis were derived from analysing the inducing and blocking mechanisms and the related issues. The innovation systems approach was chosen because of its ability to provide insights into key industry players, their network interactions and the institutional setup within which they work together to develop, diffuse and use their products. The data needed for the analysis stated above included information related to the development, diffusion and use of ethanol and biodiesel; that is, details about the industry actors and their activities, industry networks, product standards, excise arrangements
Nielsen, Jason D.
A strong biofuel industry in Australia has the potential to provide numerous benefits to the nation and its peoples. The benefits include; reduced emissions of greenhouse gases and harmful particulate matter, a boost to rural development goals, enhanced fuel security and a lower balance of payments. For biofuels to be seriously considered as alternatives to traditional petroleum based automotive fuels they must be economically viable. The findings from a series of Australian Bureau of Agricultural and Resource Economics (ABARE) investigations suggest that ethanol and biodiesel production would be economically viable, in the Australian context, with oil prices in the range of 30-40 USD a barrel. Despite the price of oil being in or above this range for over two years a strong home grown biofuel industry has failed to develop in Australia. The purpose of this master's thesis therefore is to identify the critical issues facing biofuel industry development in Australian and to propose possible policy and private sector strategies for dealing with them. The analysis was done in the following three steps; the first was to map the development of the ethanol and biodiesel industries, the second was to analyse the performance of the industries overtime and the third was to identify the mechanisms which have either induced or blocked their growth. The strategies proposed by this thesis were derived from analysing the inducing and blocking mechanisms and the related issues. The innovation systems approach was chosen because of its ability to provide insights into key industry players, their network interactions and the institutional setup within which they work together to develop, diffuse and use their products. The data needed for the analysis stated above included information related to the development, diffusion and use of ethanol and biodiesel; that is, details about the industry actors and their activities, industry networks, product standards, excise arrangements
Full Text Available The purpose of this paper is to identify the key elements that define the new European health policy. We observed that the health policy actually appeared to be an enclave within the integration process. The development of health policy in the new Member States followed a common pattern. Therefore, the European health policy reflected a general desire on behalf of the members to have more clarity of the rules in this area, given the different interpretation of the rules by different Member States.The Lisbon Treaty does not bring substantive changes regarding the public health policy, therefore the Member States shall keep their competence in defining the organization and financing this domain. However, the EU2020 Strategy states that “Europe faces a moment of transformation”. Therefore, the “Europeanization” of health policy could lead to the positive developments that all EU citizens are expecting.
Science and policy in health and medicine have interacted in new ways in Britain since 1945. The relationship between research and policy has a history. The changing role of social medicine, the rise of health services research and "customer contractor" policies in government have been important. The relationship between research and policy has been analysed by different schools of thought. This chapter categorises them as several groups: "evidence-based", "journalism", "sociology of scientific knowledge" and "science policy studies". The chapters in the book illuminate aspects of these changing relationships. The role of chronic disease epidemiology, of new networks in public health, of media-focussed activism, and of health technology and its advocates have been more important than political interest. PMID:16212725
Full Text Available Abstract Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values
Alfrey, Laura; Brown, Trent D.
The concept of "health literacy" is becoming increasingly prominent internationally, and it has been identified as one of the five key propositions that underpin the forthcoming Australian Curriculum: Health and Physical Education (ACHPE). The ACHPE is one of few national curricula to explicitly refer to health literacy, identifying it…
Jones, Molly; Barclay, Alan W; Brand-Miller, Jennie C; Louie, Jimmy Chun Yu
This study aimed to examine the dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents, as well as the major food groups contributing to GL, in the recent 2011-2012 Australian Health Survey. Plausible food intake data from 1876 children and adolescents (51 % boys), collected using a multiple-pass 24-h recall, were analysed. The GI of foods was assigned based on a step-wise published method using values from common GI databases. Descriptive statistics were calculated for dietary GI, GL and contribution to GL by food groups, stratified by age group and sex. Linear regression was used to test for trends across age groups for BMI, dietary GI and GL, and intakes of energy, nutrients and food groups. Pearson's χ 2 test was used to test for differences between age groups for categorical subject characteristic variables. Mean dietary GI and GL of participants were 55·5 (sd 5·3) and 137·4 (sd 50·8), respectively. The main contributors to dietary GL were starchy foods: breads, cereal-based dishes, breakfast cereals, flours, grains and potatoes accounted for 41 % of total GL. Sweetened beverages, fruit and vegetable juices/drinks, cake-type desserts and sweet biscuits contributed 15 %. No significant difference (at P<0·001) was observed between sexes. In conclusion, Australian children and adolescents appear to consume diets with a lower GI than European children. Exchanging high-GI foods for low-GI alternatives within core and non-core foods may improve diet quality of Australian children and adolescents. PMID:27171604
Muscat, Danielle M.; Smith, Sian; Dhillon, Haryana M; Morony, Suzanne; Davis, Esther L.; Luxford, Karen; Shepherd, Heather L; Hayen, Andrew; Comings, John; Nutbeam, Don; McCaffery, Kirsten
Background Adult education institutions have been identified as potential settings to improve health literacy and address the health inequalities that stem from limited health literacy. However, few health literacy interventions have been tested in this setting. Methods Feasibility study for an RCT of the UK Skilled for Health Program adapted for implementation in Australian adult education settings. Implementation at two sites with mixed methods evaluation to examine feasibility, test for ch...
Brandert, Kathleen; McCarthy, Claudine; Grimm, Brandon; Svoboda, Colleen; Palm, David; Stimpson, Jim P
There is growing recognition that health goals are more likely to be achieved and sustained if programs are complemented by appropriate changes in the policies, systems, and environments that shape their communities. However, the knowledge, skills, and abilities needed to create and implement policy are among the major needs identified by practitioners at both the state and local levels. This article describes the structure and content of the Nebraska Health Policy Academy (the Academy), a 9-month program developed to meet the demand for this training. The Academy is a competency-based training program that aims to increase the capacity of Nebraska's state and local public health staff and their community partners to use public health policy and law as a public health tool. Our initiative allows for participation across a large, sparsely populated state; is grounded in adult learning theory; introduces the key principles and practices of policy, systems, and environmental change; and is offered free of charge to the state's public health workforce. Challenges and lessons learned when offering workforce development on public health policy efforts are discussed. PMID:24831286
Cavico, Frank J.; Bahaudin G. Mujtaba
This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conc...
Brusse, Carl; McAullay, Daniel; Dowden, Michelle
Background Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited. Objective The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit? Methods We conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas. Results The review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion
Franke, Carmen C D; Paton, Barbara C; Gassner, Lee-Anne J
Mental illness is among the greatest causes of disability, diminished quality of life and reduced productivity. Mental health policy aims to reform services to meet consumers' needs and one of the strategies is to increase the number of consumers working in the mental health service system. In South Australia, the Peer Work Project was established to provide a program for the training of consumers to work alongside mental health services. The project developed a flexible training pathway that consisted of an information session, the Introduction to Peer Work (IPW) course and further training pathways for peer workers. External evaluation indicated that the IPW course was a good preparation for peer workers, but a crucial factor in the implementation process of employing peer workers was commitment and leadership within the organisation in both preparing the organisation and supporting peer workers in their role. To assist organisations wanting to employ peer workers, a three step model was developed: prepare, train and support. The project has been successful in establishing employment outcomes for IPW graduates. The outcomes increased with time after graduation and there was a shift from voluntary to paid employment. PMID:21128581
Hooff, M.V.; McFarlane, A.C.; Davies, C.E.; Searle, A.K.; Fairweather-Schmidt, A.K.; Verhagen, A.F.; Benassi, H.; Hodson, S.E.
BACKGROUND: The Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (MHPWS) is the first study of mental disorder prevalence in an entire military population. OBJECTIVE: The MHPWS aims to establish mental disorder prevalence, refine current ADF mental health screening methods
It is implied by governing organizations that Australia is presently experiencing its first national curriculum reform, when as the title suggests it is the second. However, until now Australian states and territories have been responsible for the education curriculum delivered within schools. The present national curriculum reform promises one…
Rizvi, Narjis; Nishtar, Sania
The interface between national health policy and women's health needs is complex in developing countries like Pakistan. This paper aims to assess if Pakistan's national health policy 2001 is relevant and appropriate to women's health needs. Through review of existing data on women, a profile of women's health needs was developed which was transformed into framework of analysis. This framework indicates that Pakistani women's health needs are determined by gender disparities in health and health-related sectors. Comparison of national health policy with women's health needs framework reveals that although policy focuses on women's health through prioritization of gender equity, it is however addressed as an isolated theme without acknowledging the vital role gender inequalities in health and health-related sectors play in defining women's health needs. Moreover, gender equity is translated as provision of reproductive health services to married mothers, ignoring various critical overarching issues of women's life such as sexual abuse, violence, induced abortion, etc. Health systems strengthening strategies are though suggested but these fails to recognize main obstacles of utilization of healthcare services by women including non-availability of female healthcare providers and gender-based obstacles to healthcare utilization such as illiteracy, lack of empowerment to make decisions related to health, etc. In order to be relevant and appropriate to women's health needs the policy should: (1) use gender equity in health and health-related sectors as an approach to develop a healthy policy (2) expand the focus from reproductive health to life cycle approach to address all issues around women's life (3) strengthen health systems through creation of gender equity among all cadres of health providers (4) tailoring health interventions to counter gender-based obstacles to utilization of healthcare services and (5) dissemination interventions for behavior change. PMID
Frank J. Cavico
Full Text Available This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace.
Labonté, Ronald; Gagnon, Michelle L
Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do
Full Text Available Abstract Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are
Kelaher Margaret; Ferdinand Angeline; Taylor Hugh
Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, ...
Vega Romero, Román
I propose in this work a critical, egalitarian, and pluralist methodological perspective for health policy and social justice evaluation. It is the result of a reflection departing from the challenges posed to social justice by the actual Colombian Health System Reform. This methodological approach is grounded in a post-structuralist and critical systems thinking perspective of evaluation, looks for the deconstruction of neo-liberal health policies, and promotes, at the same time, plural and ...
Full Text Available As the complexity and interconnectedness of present-day social-ecological systems become steadily more apparent, there is increasing pressure on governments, policy makers, and managers to take a systems approach to the challenges facing humanity. However, how can this be done in the face of system complexity and uncertainties? In this paper we briefly discuss practical ways that policy makers can take up the systems challenge. We focus on resilience thinking, and the use of influence diagrams, causal-loop diagrams, and system archetypes. As a case study, set in the context of the climate-energy-water nexus, we use some of these system concepts and tools to carry out an initial exploration of factors that can affect the resilience of the Australian National Electricity Market. We stress the need for the electricity sector to prepare for the impacts of global change by encouraging innovation and diversity, supporting modularity and redundancy, and embracing the need for a policy making approach that takes account of the dynamics of the wider social-ecological system. Finally, taking a longer term view, we conclude by recommending that policy makers work to reduce reliance on conventional market mechanisms, institute continuing cross-sector dialogue, and promote basic education in system dynamics.
Holden, Libby; Ware, Robert S.; Lee, Christina
This article used data from 5,171 young women participating in the Australian Longitudinal Study on Women's Health, a nationally representative longitudinal cohort study, to identify longitudinal trajectory patterns of mental health across 6 surveys over 16 years of early adulthood, from age 18-23 to age 34-39. In addition, we identified both…
Smith-Merry, Jennifer; Caple, Andrew
Adverse events in mental health care occur frequently and cause significant distress for those who experience them, derailing treatment and sometimes leading to death. These events are clustered around particular aspects of care and treatment and are therefore avoidable if practices in these areas are strengthened. The research reported in this article takes as its starting point coronial recommendations made in relation to mental health. We report on those points and processes in treatment and discharge where coronial recommendations are most frequently made. We then examine the legislative requirements around these points and processes in three Australian States. We find that the key areas that need to be strengthened to avoid adverse events are assessment processes, communication and information transfer, documentation, planning and training. We make recommendations for improvements in these key areas. PMID:24804534
Jamieson Lisa M
Full Text Available Abstract Objectives To determine oral health literacy (REALD-30 and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. Methods 468 participants (aged 17-72 years, 63% female completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate modelling was used to calculate risk indicators for poor self-reported oral health. Results REALD-30 scores were lower among those who believed teeth should be infrequently brushed, believed cordial was good for teeth, did not own a toothbrush or owned a toothbrush but brushed irregularly. Tooth removal risk indicators included being older, problem-based dental attendance and believing cordial was good for teeth. Poor self-rated oral health risk indicators included being older, healthcare card ownership, difficulty paying dental bills, problem-based dental attendance, believing teeth should be brushed infrequently and irregular brushing. Perceived need for dental care risk indicators included being female and problem-based dental attendance. Perceived gum disease risk indicators included being older and irregular brushing. Feeling uncomfortable about oro-facial appearance risk indicators included problem-based dental attendance and irregular brushing. Food avoidance risk indicators were being female, difficulty paying dental bills, problem-based dental attendance and irregular brushing. Poor oral health-related quality of life risk indicators included difficulty paying dental bills and problem-based dental attendance. Conclusions REALD-30 was significantly associated with oral health literacy-related outcomes. Oral health literacy-related outcomes were risk indicators for each of the poor self-reported oral health domains among this marginalised population.
Van Hooff, Miranda; McFarlane, Alexander C; Christopher E. Davies; Searle, Amelia K.; Fairweather-Schmidt, A Kate; Verhagen, Alan; Benassi, Helen; Stephanie E Hodson
Background: The Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (MHPWS) is the first study of mental disorder prevalence in an entire military population.Objective: The MHPWS aims to establish mental disorder prevalence, refine current ADF mental health screening methods, and identify specific occupational factors that influence mental health. This paper describes the design, sampling strategies, and methodology used in this study.Method: At Phase 1, approximately ...
Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn
Background Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Healt...
Ádám, Balázs, E-mail: email@example.com [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: firstname.lastname@example.org [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: email@example.com [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: firstname.lastname@example.org [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: email@example.com [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: firstname.lastname@example.org [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: email@example.com [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: firstname.lastname@example.org [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others
The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.
The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals
Many advanced market democracies pursue social justice by bundling together a range of programmes represented as active social policy. Northern European exemplars sanction employment as an economic and social citizen's civic obligation, promote lifelong learning and place welfare payments as a last resort. In the United States, market-based…
Hansen, David P; Gurney, Phil; Morgan, Gary; Barraclough, Bruce
The CSIRO (Commonwealth Scientific and Industrial Research Organisation) and the Queensland Government have jointly established the Australian e-Health Research Centre (AEHRC) with the aim of developing innovative information and communication technologies (ICT) for a sustainable health care system. The AEHRC, as part of the CSIRO ICT Centre, has access to new technologies in information processing, wireless and networking technologies, and autonomous systems. The AEHRC's 50 researchers, software engineers and PhD students, in partnership with the CSIRO and clinicians, are developing and applying new technologies for improving patients' experience, building a more rewarding workplace for the health workforce, and improving the efficiency of delivering health care. The capabilities of the AEHRC fall into four broad areas: smart methods for using medical data; advanced medical imaging technologies; new models for clinical and health care interventions; and tools for medical skills development. Since its founding in 2004, new technology from the AEHRC has been adopted within Queensland (eg, a mobile phone-based cardiac rehabilitation program), around Australia (eg, medical imaging technologies) and internationally (eg, our clinical terminology tools). PMID:21401490
Maria Grasiela Teixeira Barroso; Neiva Francenely Cunha Vieira; Zulene Maria de Vasconcelos Varela
The national curriculum directives of health area graduation courses and texts about interdisciplinary,health promotion/education and public policies framed the discussion about health education,which,in this context,is an area of political pedagogical knowledge, considering that its knowing and doing have been historically determined by social and economical conditions that guide public policies.This work aimed at motivating readers to open up psycho-pedagogical,cultural and operational scen...
@@ Introduction The Australian Research Council(ARC) is the Australian Government's main agency for allocating research funding to academics and researchers in Australian universities.Its mission is to deliver policy and programs that advance Australian research and innovation globally and benefit the community.
Gambhir, RS; Gupta, T
Dental diseases are a significant public health menace having a substantial impact on the quality of life which in turn affects the daily performance and general life satisfaction. There is a vast difference in health status including the oral health between urban and rural population of India and in other developing countries. The existing situation demands the formulation and implementation of National Oral Health Policy in India in order to expand the oral health care to make it more affordable, and reachable. An extensive literature search was conducted using various search engines in order to include relevant information in the review. Number of keywords and their combinations were used in order to extract appropriate data. Finally 24 out of 35 articles were selected upon detailed reading. The present paper focusses on some of the important subjects that can be considered while formulation of a National Oral Health Policy for the benefits of both the dental profession and community as a whole. There is a need of dental health planners and policy makers that have relevant qualifications and training in public health dentistry to understand the unique needs and resources for the development of an effective oral health policy. Professional dental organizations can also support government programs to provide basic oral health needs of extensive underserved population of this country.
Gambhir, R S; Gupta, T
Dental diseases are a significant public health menace having a substantial impact on the quality of life which in turn affects the daily performance and general life satisfaction. There is a vast difference in health status including the oral health between urban and rural population of India and in other developing countries. The existing situation demands the formulation and implementation of National Oral Health Policy in India in order to expand the oral health care to make it more affordable, and reachable. An extensive literature search was conducted using various search engines in order to include relevant information in the review. Number of keywords and their combinations were used in order to extract appropriate data. Finally 24 out of 35 articles were selected upon detailed reading. The present paper focusses on some of the important subjects that can be considered while formulation of a National Oral Health Policy for the benefits of both the dental profession and community as a whole. There is a need of dental health planners and policy makers that have relevant qualifications and training in public health dentistry to understand the unique needs and resources for the development of an effective oral health policy. Professional dental organizations can also support government programs to provide basic oral health needs of extensive underserved population of this country. PMID:27144077
The educational performance of Aboriginal Australians lags behind non-Indigenous Australians with the gap increasing the longer students remain at school. The Australian government has released its Closing the Gap policy with the specific intent to redress gaps in health, education and housing, as these are seen as key indicators to life success.…
Bailie, Ross; Bailie, Jodie; Chakraborty, Amal; Swift, Kevin
The quality of data derived from primary healthcare electronic systems has been subjected to little critical systematic analysis, especially in relation to the purported benefits and substantial investment in electronic information systems in primary care. Many indicators of quality of care are based on numbers of certain types of patients as denominators. Consistency of denominator data is vital for comparison of indicators over time and between services. This paper examines the consistency of denominator data extracted from electronic health records (EHRs) for monitoring of access and quality of primary health care. Data collection and analysis were conducted as part of a prospective mixed-methods formative evaluation of the Commonwealth Government's Indigenous Chronic Disease Package. Twenty-six general practices and 14 Aboriginal Health Services (AHSs) located in all Australian States and Territories and in urban, regional and remote locations were purposively selected within geographically defined locations. Percentage change in reported number of regular patients in general practices ranged between -50% and 453% (average 37%). The corresponding figure for AHSs was 1% to 217% (average 31%). In approximately half of general practices and AHSs, the change was ≥ 20%. There were similarly large changes in reported numbers of patients with a diagnosis of diabetes or coronary heart disease (CHD), and Indigenous patients. Inconsistencies in reported numbers were due primarily to limited capability of staff in many general practices and AHSs to accurately enter, manage, and extract data from EHRs. The inconsistencies in data required for the calculation of many key indicators of access and quality of care places serious constraints on the meaningful use of data extracted from EHRs. There is a need for greater attention to quality of denominator data in order to realise the potential benefits of EHRs for patient care, service planning, improvement, and policy. We
Urbanowicz, Anna; Downs, Jenny; Bebbington, Ami; Jacoby, Peter; Girdler, Sonya; Leonard, Helen
This study assessed factors that could influence equipment and respite services use among Australian families caring for a girl/woman with Rett syndrome and examined relationships between use of these resources and the health of female caregivers. Data was sourced from questionnaires completed by families (n=170) contributing to the Australian…
Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.
Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853
Diderichsen, Finn; Andersen, Ingelise; Manual, Celie; Andersen, Anne-Marie Nybo; Bach, Elsa; Baadsgaard, Mikkel; Brønnum-Hansen, Henrik; Hansen, Finn Kenneth; Jeune, Bernard; Jørgensen, Torben; Søgaard, Jes
The review ”Health inequality – determinants and policies” identifies key-areas to be addressed with the aim to reduce the social inequality in health. The general life expectancy has steadily been increasing, but the data reveals marked social inequalities in health as well as life expectancy. The...... review seeks to identify the causes of this social inequality. The analysis finds 12 areas of great importance for the inequality in health. This is i.e. early child development, schooling and education, the health behavior of the population, and the role of the health system. Within each of the 12 areas......, key interventions are suggested to counteract the negative impact of the different determinants....
... OFFICE Health Information Technology Policy Committee Vacancy AGENCY: Government Accountability Office... Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health IT.... ARRA requires that one member have expertise in health information privacy and security. Due to...
Koo, Fung Kuen; Kwok, Cannas; White, Kate; D'Abrew, Natalie; Roydhouse, Jessica K
In Australia, women from non-English-speaking backgrounds participate less frequently in breast cancer screening than English-speaking women, and Chinese immigrant women are 50% less likely to participate in breast examinations than Australian-born women. Chinese-born Australians comprise 10% of the overseas-born Australian population, and the immigrant Chinese population in Australia is rapidly increasing. We report on the strategies used in a pilot breast health promotion program, Living with Healthy Breasts, aimed at Cantonese-speaking adult immigrant women in Sydney, Australia. The program consisted of a 1-day education session and a 2-hour follow-up session. We used 5 types of strategies commonly used for cultural targeting (peripheral, evidential, sociocultural, linguistic, and constituent-involving) in a framework of traditional Chinese philosophies (Confucianism, Taoism, and Buddhism) to deliver breast health messages to Chinese-Australian immigrant women. Creating the program's content and materials required careful consideration of color (pink to indicate femininity and love), symbols (peach blossoms to imply longevity), word choice (avoidance of the word death), location and timing (held in a Chinese restaurant a few months after the Chinese New Year), communication patterns (the use of metaphors and cartoons for discussing health-related matters), and concern for modesty (emphasizing that all presenters and team members were female) to maximize cultural relevance. Using these strategies may be beneficial for designing and implementing breast cancer prevention programs in Cantonese-speaking Chinese immigrant communities. PMID:22172170
Nuramy J. Gutiérrez
Full Text Available This work reviews social changes occurring in Venezuela during the last two decades, examining how they led to the development of a new health policy. Initially, the political context of the nineties is examined; this was a time when the neoliberal politics of the 1980’s had a demonstrable impact on the living conditions and health status of the population. By 1999 social and political events led to a new Constitution which provided the juridical and legal framework for a new health policy. The conceptualization of health and the model of health care which arose from the constitutional process are considered, as well as the reaction of the dominant economic and political sectors to the new policies imposed by constitutional mandate. The emergence of Barrio Adentro and other social missions is analyzed as an essential factor in the initiation of structural changes within the country and its health institutions. The Barrio Adentro program is described in detail, along with key steps in the development of the Venezuelan National Public Health System. Finally, the impact of these new health policies on the quality of life of the Venezuelan population is delineated.
McKeganey, Neil; Russell, Christopher
In December 2012, Australia became the first country to require all tobacco products be sold solely in standardised or 'plain' packaging, bereft of the manufacturers' trademarked branding and colours, although retaining large graphic and text health warnings. Following the publication of Sir Cyril Chantler's review of the evidence on the effects of plain tobacco packaging, the Ministers of the United Kingdom Parliament voted in March 2015 to implement similar legislation. Support for plain packaging derives from the belief that tobacco products sold in plain packs have reduced appeal and so are more likely to deter young people and non-smokers from starting tobacco use, and more likely to motivate smokers to quit and stay quit. This article considers why support for the plain packaging policy has grown among tobacco control researchers, public health advocates and government ministers, and reviews Australian survey data that speak to the possible introductory effect of plain packaging on smoking prevalence within Australia. The article concludes by emphasising the need for more detailed research to be undertaken before judging the capacity of the plain packaging policy to deliver the multitude of positive effects that have been claimed by its most ardent supporters. PMID:26041731
Full Text Available A primary societal goal for aging is enabling older people to continue to live well as long as possible. The evidence base around aging well (‘healthy’, ‘active’ and ‘successful’ aging has been constructed mainly from academic and professional conceptualizations of mortality, morbidity, functioning, and psychological well-being with some attention to lay views. Our study aims to inform action on health promotion to achieve aging well as conceptualized by qualitative research identifying what older Australians themselves value most: continuing to live as long as possible in the community with independence in daily living, and good self-rated health and psychological well-being. Multivariate survival analyses from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA program found that important threats to aging well for the total sample over a 12 year period were chronological age, multi-morbidity, low perceived social support, low nutritional score, and being underweight. For men, threats to aging well were low strain, perceived inadequacy of social activity, and being a current smoker. For women, urinary incontinence, low physical activity and being underweight were threats to aging well. The findings indicate that healthy lifestyles can assist aging well, and suggest the value of taking gender into account in health promotion strategies.
@@ 1 Introduction At present, there is a myriad of contradictions between international illicit drug policy and good, evidence-based public health policy. Largely to blame are the unrealistic goals which policymakers set themselves ten years ago when Pino Arlacchi, the Executive Director of the United Nations Office on Drugs and Crime (UNODC), announced plans to create a drug-free world' and to eliminate or significantly reduce the illicit cultivation of the coca bush, the cannabis plant and the opium poppy by the year 2008.
Squire, Lyn; Jones, Andrew M.; Thomas, Ranjeeta
The Global Development Network’s (GDN) project “Evaluating Innovative Health Programs” (EIHP), funded by the Bill & Melinda Gates Foundation, seeks to inform policy on the effectiveness of health solutions that have the potential to improve health outcomes in developing countries. It evaluates the impact of nineteen programs from across developing and transition countries that focus on the health-related Millennium Development Goals (MDGs) of reducing child and maternal mortality, and halting...
Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert
Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system. PMID:22403246
Full Text Available Abstract Background High consumption of sugar sweetened beverages (SSBs has been linked to unhealthy weight gain and nutrition related chronic disease. Intake of SSB among children remains high in spite of public health efforts to reduce consumption, including restrictions on marketing to children and limitations on the sale of these products in many schools. Much extant literature on Australian SSB consumption is out-dated and lacks information on several key issues. We sought to address this using a contemporary Australian dataset to examine purchase source, consumption pattern, dietary factors, and demographic profile of SSB consumption in children. Methods Data were from the 2007 Australian National Children's Nutrition and Physical Activity Survey, a representative random sample of 4,834 Australian children aged 2-16 years. Mean SSB intake by type, location and source was calculated and logistic regression models were fitted to determine factors associated with different levels of consumption. Results SSB consumption was high and age-associated differences in patterns of consumption were evident. Over 77% of SSB consumed was purchased via supermarkets and 60% of all SSB was consumed in the home environment. Less than 17% of SSB was sourced from school canteens and fast food establishments. Children whose parents had lower levels of education consumed more SSB on average, while children whose parents had higher education levels were more likely to favour sweetened juices and flavoured milks. Conclusions SSB intake by Australian children remains high and warrants continued public health attention. Evidence based and age-targeted interventions, which also recognise supermarkets as the primary source of SSB, are recommended to reduce SSB consumption among children. Additionally, education of parents and children regarding the health consequences of high consumption of both carbonated and non-carbonated SSBs is required.
Yates, Christine; Partridge, Helen; Bruce, Christine
Given identified synergies between information use and health status greater understanding is needed about how people use information to learn about their health. This paper presents the findings of preliminary research into health information literacy. Analysis of data from semi-structured interviews revealed six different ways ageing Australians…
This document traces Australian training and literacy policy developments from 1974 to 1998. The document begins with a brief discussion of the global political, educational, social, and economic trends that have affected Australia's training and literacy policies. Discussed next are major events of the four policy "epochs" in Australia's…
Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J
Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap. PMID:27041127
Full Text Available Abstract Background While participatory social network analysis can help health service partnerships to solve problems, little is known about its acceptability in cross-cultural settings. We conducted two case studies of chronic illness service partnerships in 2007 and 2008 to determine whether participatory research incorporating social network analysis is acceptable for problem-solving in Australian Aboriginal health service delivery. Methods Local research groups comprising 13–19 partnership staff, policy officers and community members were established at each of two sites to guide the research and to reflect and act on the findings. Network and work practice surveys were conducted with 42 staff, and the results were fed back to the research groups. At the end of the project, 19 informants at the two sites were interviewed, and the researchers conducted critical reflection. The effectiveness and acceptability of the participatory social network method were determined quantitatively and qualitatively. Results Participants in both local research groups considered that the network survey had accurately described the links between workers related to the exchange of clinical and cultural information, team care relationships, involvement in service management and planning and involvement in policy development. This revealed the function of the teams and the roles of workers in each partnership. Aboriginal workers had a high number of direct links in the exchange of cultural information, illustrating their role as the cultural resource, whereas they had fewer direct links with other network members on clinical information exchange and team care. The problem of their current and future roles was discussed inside and outside the local research groups. According to the interview informants the participatory network analysis had opened the way for problem-solving by “putting issues on the table”. While there were confronting and ethically
Michaud, Josh; Kates, Jennifer
Attention to global health diplomacy has been rising but the future holds challenges, including a difficult budgetary environment. Going forward, both global health and foreign policy practitioners would benefit from working more closely together to achieve greater mutual understanding and to advance respective mutual goals.
Full Text Available We analyzed whether further education in young adult and mid-life [adult educational mobility] influences physical functioning and depressive symptoms in women.14247 women born 1973-78 (younger cohort and 13715 women born 1946-51 (mid-aged cohort from the Australian Longitudinal Study on Women's Health were followed for 14-16 years. Measures were the Short-Form 36 Health Survey physical functioning subscale (SF-36 PF and Centre for Epidemiologic Studies 10-item Depression Scale (CESD-10. Linear mixed modelling, accounting for time varying covariates, assessed the influence of further education on physical functioning and depressive symptoms over time. Sensitivity analysis to assess the impact of missing data was conducted using multiple imputation.Compared to younger women with a pre-existing high level of education, women gaining further education (up to age 39 years from low levels had lower SF-36 PF scores (poorer physical functioning (fully adjusted beta estimates (95%CIs -1.52 (-2.59, -0.44 while those gaining further education from middle to high levels showed equivalent SF-36 PF scores (-0.08 (-0.61, 0.44. A similar pattern was shown for CESD-10 scores (0.78 (0.29, 1.25; -0.02 (-0.26, 0.21, respectively where higher scores represented more depressive symptoms. For mid-age women, further education from a middle to high level resulted in equivalent SF-36 PF scores (-0.61 (-1.93,0.71 but higher CESD-10 scores (0.49 (0.11, 0.86, compared to highly educated women.Women who delay further education until they are aged between their 40s and 60s can improve or maintain their physical functioning but may have missed the critical time to minimise depressive symptomatology. Public health policy should focus on encouraging women to upgrade their educational qualifications earlier in life in order to potentially offset the negative associations between their initial lower socio-economic position class of origin and their mental health.
... OFFICE Health Information Technology Policy Committee Appointment AGENCY: Government Accountability... Act of 2009 (ARRA) established the Health Information Technology Policy Committee to make recommendations on the implementation of a nationwide health information technology infrastructure to the...
Lynch, A J J; Thackway, R; Specht, A; Beggs, P J; Brisbane, S; Burns, E L; Byrne, M; Capon, S J; Casanova, M T; Clarke, P A; Davies, J M; Dovers, S; Dwyer, R G; Ens, E; Fisher, D O; Flanigan, M; Garnier, E; Guru, S M; Kilminster, K; Locke, J; Mac Nally, R; McMahon, K M; Mitchell, P J; Pierson, J C; Rodgers, E M; Russell-Smith, J; Udy, J; Waycott, M
Mitigating the environmental effects of global population growth, climatic change and increasing socio-ecological complexity is a daunting challenge. To tackle this requires synthesis: the integration of disparate information to generate novel insights from heterogeneous, complex situations where there are diverse perspectives. Since 1995, a structured approach to inter-, multi- and trans-disciplinary(1) collaboration around big science questions has been supported through synthesis centres around the world. These centres are finding an expanding role due to ever-accumulating data and the need for more and better opportunities to develop transdisciplinary and holistic approaches to solve real-world problems. The Australian Centre for Ecological Analysis and Synthesis (ACEAS ) has been the pioneering ecosystem science synthesis centre in the Southern Hemisphere. Such centres provide analysis and synthesis opportunities for time-pressed scientists, policy-makers and managers. They provide the scientific and organisational environs for virtual and face-to-face engagement, impetus for integration, data and methodological support, and innovative ways to deliver synthesis products. We detail the contribution, role and value of synthesis using ACEAS to exemplify the capacity for synthesis centres to facilitate trans-organisational, transdisciplinary synthesis. We compare ACEAS to other international synthesis centres, and describe how it facilitated project teams and its objective of linking natural resource science to policy to management. Scientists and managers were brought together to actively collaborate in multi-institutional, cross-sectoral and transdisciplinary research on contemporary ecological problems. The teams analysed, integrated and synthesised existing data to co-develop solution-oriented publications and management recommendations that might otherwise not have been produced. We identify key outcomes of some ACEAS working groups which used synthesis to
Jayasinghe, Upali W; Harris, Mark Fort; Parker, Sharon M.; Litt, John; van Driel, Mieke; Mazza, Danielle; Del Mar, Chris; Lloyd, Jane; Smith, Jane; Zwar, Nicholas; Taylor, Richard; ,
Background Limited evidence exists regarding the relationship between health literacy and health-related quality of life (HRQoL) in Australian patients from primary care. The objective of this study was to investigate the impact of health literacy on HRQoL in a large sample of patients without known vascular disease or diabetes and to examine whether the difference in HRQoL between low and high health literacy groups was clinically significant. Methods This was a cross-sectional study of base...
Heiman, Harry J; Smith, L Lerissa; McKool, Marissa; Mitchell, Denise N; Roth Bayer, Carey
The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s), health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach. PMID:26703657
Harry J. Heiman
Full Text Available The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s, health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach.
Financially comfortable, with ample spare time and much better health, older people travel more than ever and to more adventurous destinations. Taking Australian senior adventure travellers to Peru as an example, travel health preparations need to take into account the phenomenon 'senior traveller', the destination with its attractions and challenges, and age-related changes and restrictions. The need for routine travel health advice, vaccinations and prophylaxis remains unchanged. However, more emphasis should be placed on locality-specific issues so that age-appropriate advice and preparations maximize the chances for a safe and memorable travel experience. PMID:22459635
Undernutrition is widespread in Australian Aboriginal infants and children and is associated with high rates of infections, particularly of the respiratory and gastrointestinal systems. Maternal ill-health and undernutrition seem to be neglected factors which contribute to the high incidence of low birthweight in Aboriginal babies and to their poor growth in the first five years of life. More effective preventive programmes are needed to help overcome these problems. PMID:2514558
Calum R. Paton
Full Text Available Let us start with an example of health policy analysis in action. Within that category of countries loosely known as ‘the West’, quite basic differences exist in attitudes to health policy and also actual health policy. Comparing the US with mainland Europe and indeed Canada, for example, one perceives a difference in attitude on the part of the majority towards collectivism and individualism in access to, provision of and financing of healthcare. The explanation for policy and system differences—for example, between the US healthcare system(s and the various NHSs of the UK countries (England, Scotland, Wales and Northern Ireland—is commonly framed in terms of ‘ideology’ but there are also ‘institutional’ explanations (1. Additionally, however, popular attitudes or ‘values’ may be taken as autonomous ‘inputs’ into the explanation (e.g. ‘American values prevent the enactment of an NHS’ or, at least in part, derived from or influenced by institutional reality. If, for example, there is no chance of a bill to establish an NHS or a comprehensive system of public health insurance passing in Washington, then reformers over time trim not only their legislative ambitions, but also their very way of thinking about the issue.
Erjavec, Emil; Lovec, Marko
In 2008, the ministers of agriculture of European Union member states made a political agreement on the Common Agricultural Policy reform, also known as the Health Check. The reform coincided with three things: the ongoing Doha round of the World Trade Organization negotiations
Background Increasing demand for services and rising health care costs create pressures within the Australian health care system and result in higher health insurance premiums and out-of-pocket costs for consumers. Objective To measure changes in consumer views on the quality of the Australian health care system, contributors to rising costs and attitudes towards managing these costs. Methods Two computer-assisted telephone interviews were conducted in 2006 (533 respondents) and 2015 (1318 respondents) and results compared. Results More respondents in 2015 rated the Australian health care system ‘very adequate’ than in 2006 (22.3% vs 8.3%; Odds Ratio OR 3.2, 99% CI 2.1, 5.1) with fewer ‘concerned’ or ‘fairly concerned’ about the health care costs (69.0% vs 85.7%; OR 0.37, 99% CI 0.25, 0.53). The 2015 respondents were more likely to identify new treatments for cancer (77% vs 65.7%; OR 1.75, 99% CI 1.30, 2.35) and community expectations for access to the latest technologies (73.8% vs 67%; OR 1.39, 99% CI 1.04, 1.86) as contributors to rising health care costs. While more 2015 respondents agreed that patients should pay a greater part of the health care costs, this remained a minority view (37.9% vs 31.7%; OR 1.32, 99% CI 0.99, 1.76). They were less likely to agree that doctors should offer medical treatments regardless of the cost and chance of benefit (63.6% vs 82.9%; OR 0.36, 99% CI 0.25, 0.50). Conclusions Satisfaction with the Australian health care system has increased over time. Consumers recognise the cost pressures and have lower expectations that all services should be provided regardless of their costs and potential benefit. Public consultation on the allocation of health care resources and involvement in health care decision-making remains important. There should be community consultation about the principles and values that should guide resource allocation decisions. PMID:27294518
The Climate Institute analysis suggests ratifying the Kyoto Protocol and implementing a national emissions trading scheme today could provide Australian farmers with an income of $1.8 billion over the period 2008-2012, due to the emissions saved by limiting land clearing. Separately, a report to the National Farmers Federation by the Allen Consulting Group earlier this year concluded that a carbon emission trading system which recognised Kyoto Protocol rules could create an additional income stream of $0.7-0.9 billion over a five year period from revenue to farmers from forestry sinks. These two studies suggest that ratification of the Kyoto Protocol and the introduction of a national emissions trading scheme could provide farmers an income stream in the order of $2.5 billion. A central tenet of the Federal Government's greenhouse policy for over a decade has been to not ratify Kyoto, but to meet its Kyoto target - a national emissions increase of 8% from 1990 levels, in the period 2008-2012. Australia's National Greenhouse Gas Accounts show that farmers, by reducing land clearing rates since 1990, have offset substantial increases in greenhouse gas emissions from other sectors, mainly energy. Official Federal Government projections show that without land clearing reductions, Australia's greenhouse emissions would be 30% above 1990 levels by 2010. Australia's farmers have been responsible for virtually the entire share of the nation's greenhouse gas emissions reductions, but their efforts, worth around $2 billion, have not been recognised or financially rewarded by the Government. By reducing land clearing, farmers have already reduced greenhouse gas emissions by about 75 million tonnes since 1990. By 2010, the savings are projected to be about 83 million tonnes. This level of emissions reductions is equivalent to eliminating the total annual emissions of New Zealand or Ireland. Over that same period, emissions from energy and transport have and continue to sky
Blacksher, Erika; Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St Peter, Robert
We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views. PMID:25607945
Full Text Available Abstract In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM; a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: • the central role of the workforce in the health sector; • the various challenges thrown up by health system reforms; • the need to anticipate the effect on the health workforce (and consequently on service provision arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs. Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH: • to move beyond the traditional approach of personnel administration to a more global concept of HRM; • to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy; • to foster a more proactive attitude among human resources (HR policy-makers and managers; • to promote the full commitment of all professionals and sectors in all phases of the process. The development of explicit human resources
Gorman, D; Douglas, M J; Conway, L; Noble, P; Hanlon, P
Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy. PMID:12802900
Becerra, Carlos; Herrera, Tania
Health workers are crucial to the performance of a health system. Their situation is critical and this has been recognized as a global problem. The main challenges are their number, distribution, skills and performance conditions. Addressing these issues must necessarily involve a multifactorial, intersectoral and international approach, where determinant factors are: educational policies, forms of recruitment, permanency and termination of contract, issues that arise throughout their working cycle. In Chile, the management of health workers does not follow a comprehensive outlook. The type, number and distribution of technicians and professionals do not respond to a nationwide planning strategy, and there is no coordination between health authorities and universities. The result is that the system is not responding to the health needs of the population, nor is fulfilling the promise of a public service career that encourages good performance, investing in its human resources. PMID:25489843
Full Text Available Health workers are crucial to the performance of a health system. Their situation is critical and this has been recognized as a global problem. The main challenges are their number, distribution, skills and performance conditions. Addressing these issues must necessarily involve a multifactorial, intersectoral and international approach, where determinant factors are: educational policies, forms of recruitment, permanency and termination of contract, issues that arise throughout their working cycle. In Chile, the management of health workers does not follow a comprehensive outlook. The type, number and distribution of technicians and professionals do not respond to a nationwide planning strategy, and there is no coordination between health authorities and universities. The result is that the system is not responding to the health needs of the population, nor is fulfilling the promise of a public service career that encourages good performance, investing in its human resources.
Roberts-Thomson Kaye F
Full Text Available Abstract Background Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1 estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years; (2 compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3 ascertain the independent contribution of those risk indicators to severe oral health impairment in this population. Methods Data were from the Aboriginal Birth Cohort (ABC study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR. Results The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7. In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6. In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6, being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6, soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6 and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4. Conclusions Severe oral health impairment was prevalent among this population. The findings
Loyola, Maria Andréa
Since the 1970s the Brazilian government has made efforts to implement a pharmaceutical policy that, in spite of a market predominantly oligopolized and dominated by multinational pharmaceutical industries, guarantees access to essential drugs for the population. In this context, in 1999, a law regarding generics was approved. This article aims at analyzing the elements that interfered in the implementation process of this law. Based on specialized bibliography, on the debate in the Brazilian press (1992-2002) and on interviews with industry members, physicians, politicians, activists and civil servants we try to show that the implementation of generics in Brazil is strongly related to the AIDS epidemic. More precisely, it is related to the successful health policy against this disease involving different actors and a variety of elements to be analyzed here, among them the policy of copycat versions of drugs, the law of universal access to anti-AIDS drugs, the struggle of organized social movements, the governmental bureaucracy implemented for fighting this epidemic and the strong mobilization of the media. PMID:21936182
Haynes, Emma; Taylor, Kate P; Durey, Angela; Bessarab, Dawn; Thompson, Sandra C
Introduction The substantial gap in life expectancy between Indigenous and non-Indigenous Australians has been slow to improve, despite increased dedicated funding. Partnerships between Australian Indigenous and mainstream Western biomedical organisations are recognised as crucial to improved Indigenous health outcomes. However, these partnerships often experience challenges, particularly in the context of Australia’s race and political relations. Methods We examined the relevant literature i...
Rahman, M Azizur; Rahman, Mohammad Mahmudur; Reichman, Suzie M; Lim, Richard P; Naidu, Ravi
Rice is an important route of arsenic (As) exposure to humans, especially populations with rice-based diets. Human health risk of As varies greatly with rice variety and country of origin. The purpose of the present study was to determine total and speciated As in Australian-grown and imported rice on sale in Australia to assess their health risk to consumers. The total As (tAs) concentrations in Australian-grown organic brown, medium grain brown, and organic white rice were 438±23, 287±03, and 283±18 μg kg(-1) dry weight (d wt), respectively. In Bangladeshi, Indian, Pakistani, and Thai rice imported and on sale in Australia, tAs concentrations were 56±05, 92±10, 82±06 and 172±24 μg kg(-1), respectively. Asian rice contained mainly inorganic As (iAs; 86-99%), whereas 18-26% of the tAs in Australian-grown rice was dimethylarsinic acid (DMA). Relatively higher concentrations of tAs in Australian-grown rice than that in imported rice of Asian origin suggest that Australian-grown rice may be a health risk for the consumers. It was estimated that Australian-grown organic brown rice can contribute up to 98% of the FAO/WHO recommended maximum tolerable daily intake limit of iAs (2.1 μg kg(-1) body wt day(-1)) for Asian immigrants. However, other Australian consumers including European immigrants are unlikely to be at risk to As from rice diets due to their lower rice consumption rates than that of Asian immigrants. The risk assessment showed that imported rice on sale in Australia was likely to pose a lower health risk to consumers than Australian-grown rice. PMID:24892387
Julia Abelson; Mita Giacomini; John Lavis; John Eyles
This background paper was prepared to inform discussion at CHEPA's Health Policy Symposium Field of Dreams: Strengthening Health Policy Scholarship in Canada on November 2, 2007. We reflect on the characteristics of Canada's health policy community in relation to the larger and more mature international health policy community: its contributions, opportunities and constraints for growing into a well institutionalized Canadian academic field. Sources consulted in preparing this document includ...
Eliane Cristina Lopes Brevilheri
Full Text Available This article aims to reflect on the territorial dimension has been addressed in the current Brazilian health policy. Provides an initial approximation of the theoretical discussion about the category territory and its implications for social policy. Then we analyze how this category was included in the principles and guidelines of the National Health System, deployed in key programs and normative instruments of health policy from 1990. It is concluded that: the territorial dimension was present from conception through SUS guideline regionalization of activities and services. In the main programs implemented in the 1990s, the territorial dimension had a character cutouts geographical and normative instruments gave centrality to the process of decentralization. However, from the 2000s, the regionalization strategy, pointing to the territorial perspective, gains greater significance. However, we still need to overcome the logic purely political-administrative and act so as to identify the real needs of the people, their potential, diversity and particularities, towards "used territory" referred to Milton Santos.
M.P.M. Bekker (Marleen)
textabstractPublic health issues, such as obesity, lung disease from air pollution or mental health complaints from living in an unsafe neighbourhood, are complex, intractable policy problems. The causes are dispersed at the individual and the collective level among different societal sector
Centers for Disease Control and Prevention, 2007
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the following areas, as they relate to nutrition: (1) Health Education; (2) Health Services and Mental Health and…
Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action. PMID:26673650
Browne-Yung, Kathryn; Ziersch, Anna; Baum, Fran; Gallaher, Gilbert
Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing. PMID:24161085
Watt, Nicola F; Gomez, Eduardo J; McKee, Martin
Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy. PMID:24072881
Azétsop, Jacquineau; Ochieng, Michael
Background There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inc...
Ivanova, Olena; Dræbel, Tania; Tellier, Siri
BACKGROUND: Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for...... (Spain, Scotland, Republic of Moldova, and Ukraine). It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policy-makers. METHODS: Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in...
Pasche, Dário Frederico; Righi, Liane Beatriz; Thomé, Henrique Inácio; Stolz, Eveline Dischkaln
The constitution of Brazil directs that the country's health system, the Unified Health System (Sistema Unico de Saúde), be politically and administratively decentralized. Nevertheless, handing over competencies, responsibilities, and resources to subnational levels, especially to municipal governments, has been a slow process, lasting almost two decades. Advances have been brought about by the Unified Health System, which, from a analytical perspective, is a public and universal system. Despite that, the decentralization process needs to overcome norms that keep all levels of management dependent on Brazil's federal Government. The subnational levels have consistently faced difficulties in performing their macromanagement functions with autonomy, especially when it comes to financing and to the establishment or organization of health care networks. Boldness and responsibility will be needed to prevent Brazil's health decentralization process from leading to fragmentation. New political agreements between different levels of government, with a reassignment of responsibilities and the enhancement of a culture of technical cooperation, are fundamental requisites to making the Unified Health System have a health policy that is truly public and universal. PMID:17341333
Although abortion for health reasons is not considered a crime in Peru, the State does not allow its inclusion in public policy, thus violating women's right to terminate a pregnancy when it affects their health. When examining the article in the Criminal Code which decriminalizes this type of abortion, provisions are identified which protect women and set the conditions to offer this type of service. This document sets the debate about the arguments used by the Peruvian State for not approving a therapeutic abortion protocol which would regulate the provision and financing of therapeutic abortion in public services, and explains why this obligation should be complied with, based on the conceptual framework of "health exception" In addition, it presents two cases brought before the judicial court in which the Peruvian State was found guilty of violating the human rights of two adolescents to whom a therapeutic abortion was denied. PMID:24100828
Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn
Studies have identified that the practices of maternity facilities and health professionals are crucial to women's experience of support and breastfeeding 'success'. The Baby Friendly Hospital Initiative (BFHI) was launched globally in 1991 to protect, promote and support breastfeeding. While a direct causal effect has not been established and critics suggest the rhetoric conflicts with women's lived experiences as new mothers, a positive association between the Initiative and breastfeeding prevalence is apparent. Internationally, impact studies have demonstrated that where the Initiative is well integrated, there is an increase in rates of breastfeeding initiation and, to a lesser extent, duration. In consideration of the known health risks associated with the use of artificial baby milks this would suggest that BFHI implementation and accreditation should be a desirable strategy for committed health facilities. However, a variation in both BFHI uptake and breastfeeding prevalence between nations has been reported. This narrative review critically discusses a variety of issues relevant to the uptake and support of breastfeeding and the BFHI, utilising Australia as a case study. Whilst it enjoys 'in principle' policy support, Australia also suffers from a lack of uniformity in uptake and perception of the benefits of BFHI at all levels of the health system. Australian and international studies have identified similar enablers and barriers to implementation. PMID:23957177
Gauld, Robin; Williams, Sheila
This article presents descriptive data from surveys that probed the use of health information by Internet users in Australia and New Zealand. Using this data, the article also contributes to understanding of factors associated with a series of Internet health information use outcomes. Four hundred six respondents (151 Australians; 255 New Zealanders) had used the Internet for health information and were asked about emailing doctors, Internet searching, taking Internet information to the doctor and perceptions of Internet information reliability. Regression analyses were conducted to examine associations between key outcomes and independent variables. A bootstrap procedure was performed to select variables used in logistic regression models. Fifty-two percent of health Internet users had emailed their doctor. Few significant differences between Australian and New Zealand responses were found. Internet use for health information was below levels found in North American and European studies, but there was similar prevalence of emailing and presenting Internet information to doctors. Emailers were more likely to believe this improved communication with doctors (OR = 3.59; 95%CI 1.95, 6.61). Frequent Internet searchers were more likely to take Internet information to their doctor (OR = 2.41; 1.47, 3.92), and believe the Internet to be a more useful information source (OR = 2.47; 1.22, 5.03). Females were less likely to email their doctor (OR = 0.47; 0.26, 0.85). More educated respondents were more likely to email their doctor (OR = 1.99; 1.16, 3.39) and to check website credentials (OR = 2.61; 1.53, 4.43). This study suggests that there is a digital divide among health care Internet users. It shows that, for males, email could have health care advantages. Doctors may need to develop strategies to deal with patients presenting with Internet information, including how to source information and check its credibility. PMID:19670005
Fogarty, Andrea S.; Chapman, Simon
Background Alcohol policy priorities in Australia have been set by the National Preventative Health Task Force, yet significant reform has not occurred. News media coverage of these priorities has not reported public health experts as in agreement and Government has not acted upon the legislative recommendations made. We investigate policy experts’ views on alcohol policy priorities with a view to establishing levels of accord and providing suggestions for future advocates. Methods We conduct...
Full Text Available In the European Union (EU, health policy and the institutional reform of health systems have been treated primarily as national affairs, and health care systems within the EU thus differ considerably. However, the health policy field is undergoing a dynamic process of Europeanization. This process is stimulated by the orientation towards a more competitive economy, recently inaugurated and known as the Lisbon Strategy, while the regulatory requirements of the European Economic and Monetary Union are stimulating the Europeanization of health policy. In addition, the so-called open method of coordination, representing a new mode of regulation within the European multi-level system, is applied increasingly to the health policy area. Diverse trends are thus emerging. While the Lisbon Strategy goes along with a strategic upgrading of health policy more generally, health policy is increasingly used to strengthen economic competitiveness. Pressure on Member States is expected to increase to contain costs and promote market-based health care provision.
Kaplan, Ida; Stow, Hardy David; Szwarc, Josef
There has been a growing recognition of the mental health needs of refugees in countries of settlement, as many are survivors of torture and other traumatic events experienced in countries of origin, during flight, and in places of temporary refuge. The challenges in providing access to services and quality mental health care arise not only from the fact that refugees generally come from cultures very different to the societies in which they settle and are not proficient in the languages of their new homes. Other significant barriers relate to the impact of the trauma and psychosocial stressors they experience despite finding apparent security. In response to the challenges, specialist agencies have developed ways of providing services that are trauma-informed, culture-informed, and holistic. This paper describes an Australian example of a mental health clinic as part of a community-based service for refugees who are survivors of torture and other traumatic events. PMID:27524758
Mills, Patj Patj Janama Robert; Dingwall, Kylie Maree; Lowell, Anne; Singer, Judy; Rotumah, Darlene; Bennett-Levy, James; Nagel, Tricia
Background Aboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community. Objective This study aimed to explore Aboriginal and Torres Strait Islander community members’ experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches. Methods Using qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings. Results Findings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake. Conclusions When designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health
Friel, S; Berry, H; Dinh, H.; O'Brien, L; Walls, HL
Background The association between food insecurity and mental health is established. Increasingly, associations between drought and mental health and drought and food insecurity have been observed in a number of countries. The impact of drought on the association between food insecurity and mental health has received little attention. Methods Population-based study using data from a nationally representative panel survey of Australian adults in which participants report behaviour, health, soc...
Full Text Available This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented.
In 2014, the Australian Federal Government attempted to de-regulate higher education fees so as to allow universities to set their own tuition fees. The associated public debate offer critical insights into how the identity of a student as a "customer" of higher education is understood and deployed when developing higher education…
Goic, Alejando; Armas, Rodolfo
The ALANAM (Association of Latin American National Academies of Medicine) statement on public health policy, issued following its 19th Congress, held October 28–30, 2010, in Santiago, Chile, declares that cardiovascular diseases, cancer, accidents and violence are the leading causes of death in the region, while in several of its member nations, emergent and re-emergent infectious diseases, malnutrition, and mother-child illnesses remain prevalent. The statement calls attention to the lack of functioning water supply and sewage systems in many villages and rural areas. After describing the social causes of the present state of public health in Latin America (poverty levels reaching upwards of 44% of the total population, or some 110 million people), it calls on governments, first, to spare no efforts in the task of eradicating extreme poverty in the short-term, and poverty in the long-term. Second, considering that about 15 million 3-to-6 year-olds have no access to education, it recommends extending educational services to these children, and to improve the quality of existing pre-school and primary education. Third, the statement calls for universal health care coverage and for equal access to good quality medical care for everyone, and for programs aimed at promoting healthy personal habits and self-care. In this regard, it also recommends that disease prevention programs be sustained over time, that national sanitary objectives be defined, and that its results be periodically reviewed. Fourth, it recommends that primary health care be extended to everyone, and that it be enhanced by improving coverage and coordination with secondary and tertiary level health care institutions. The statement lays special stress on the need for adopting public health policies aimed at lowering the cost of medicines; to this end, it calls for the creation of an official list of generic drugs. The statement ends by calling on governments to support public health research as a
Gardner, Karen; Parkinson, Anne; Banfield, Michelle; Sargent, Ginny M; Desborough, Jane; Hehir, Kanupriya Kalia
Monitoring patient experience is essential for stimulating innovation in health care and improving quality and accountability. Internationally, standardised approaches are used to collect patient experience information, but in Australian primary health care (PHC), little is known about which patient experience surveys are used and which aspects of experience they measure. This prevents routine inclusion of patient experience data in quality improvement or system performance measurement. A scoping review was undertaken to identify relevant surveys. Data on survey availability, psychometric properties, target population, method and frequency of administration were extracted. Survey items were mapped against six dimensions of patient experience described internationally. Ninety-five surveys were identified; 34 were developed for use in Australia. Surveys vary in content, size, aspects of experience measured and methods of administration. The quality of data collected and the extent to which it is used in quality improvement is unclear. Collection of patient experience data in Australian PHC is not well developed or standardised and there are few publicly available instruments. There is a need to clearly identify the purposes for which data are to be used and to develop an integrated approach that articulates these collections with other quality and performance data. Some options are discussed. PMID:27469275
Catharina Leite Matos Soares
This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from...
Tesler, Laura E; Malone, Ruth E
To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators' pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders. PMID:18923118
Transaction cost economics (TCE) has been the dominant economic paradigm for analysing contracting, and the framework has been applied in a number of health care contexts. However, TCE has particular limitations when applied to complex industry settings and there have been calls to extend the framework to incorporate dynamic theories of industrial organisation, specifically the resource-based view (RBV). This paper analyses how such calls for theoretical pluralism are particularly germane to health care markets and examines whether a combined TCE-RBV provides a more comprehensive approach for understanding the nature of contractual arrangements that have developed within the Australian private health care sector and its implications for informing policy. This Australian case study involved a series of interviews with 14 senior contracting executives from the seven major health funds (i.e. 97% of the insured population) and seven major private hospital groups (i.e. 73% of the private hospital beds). Study findings reveal that both the TCE perspective with its focus on exchange hazards, and the RBV approach with its emphasis on the dynamic nature of capabilities, each provide a partial explanation of the developments associated with contracting between health funds and hospital groups. For a select few organisations, close inter-firm relational ties involving trust and mutual commitment attenuate complex exchange hazards through greater information sharing and reduced propensity to behave opportunistically. Further, such close relational ties also provide denser communication channels for creating and transmitting more complex information enabling organisations to tap into each other's complementary resources and capabilities. For policymakers, having regard to both TCE and RBV considerations provides the opportunity to apply competition policy beyond the current static notions of efficiency and welfare gains, and cautions policymakers against specifying ex ante the
Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien
Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. PMID:25500994
Full Text Available Abstract Background The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening. Methods The 2003 BHS surveyed English-speaking Australian women aged 30–69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01. Results Of the 3,144 respondents who consented to being interviewed, 138 (4.4% had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1% reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9% had heard of the BreastScreen Australia (BSA program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys. Conclusion The
Yoder, Karen M; Edelstein, Burton L
This article describes the planning, sequential improvements, and outcomes of Indiana University School of Dentistry's annual Oral Health Policy Forum. This one-day forum for fourth-year dental students was instituted in 2005 with the Indiana Dental Association and the Children's Dental Health Project to introduce students to the health policy process and to encourage their engagement in advocacy. Following a keynote by a visiting professor, small student groups develop arguments in favor and in opposition to five oral health policy scenarios and present their positions to a mock or authentic legislator. The "legislator" critiques these presentations, noting both effective and ineffective approaches, and the student deemed most effective by fellow students receives a gift award. During the afternoon, students tour the Indiana State House, observe deliberations, and meet with legislators. In 2009, 92 percent of students reported a positive impression of the forum, up from 60 percent in 2005. Half (49 percent) in 2009 indicated that they were more inclined to become involved with the political process following the forum, up from 21 percent in 2005. Dental students' feedback became increasingly positive as the program was refined and active learning opportunities were enhanced. This model for engaging students in policy issues important to their professional careers is readily replicable by other dental schools. PMID:23225676
Boyages, Costa S
Rio+20's proposed Sustainable Development Goals have the potential to redefine the course of international action on climate change. They recognise that environmental health is inextricably linked with human health, and that environmental sustainability is of paramount importance in safeguarding global health. Competition entrants were asked to discuss ways of making global health a central component of international sustainable development initiatives and environmental policy, using one or two concrete examples PMID:24099214
Bell, Erica; Crocombe, Leonard; Campbell, Steven; Goldberg, Lynette R.; Seidel, Bastian M.
Background: No studies exist of the congruence of research in oral health to policy. This study aimed to examine the broad congruence of oral health research to policy, and implications for developing oral health research that is more policy relevant, particularly for the wider challenge of addressing unequal oral health outcomes, rather than specific policy translation issues. Methods: Bayesian-based software was used in a multi-layered method to compare the conceptual content of 127,193 oral health research abstracts published between 2000–2012 with eight current oral health policy documents from Organisation for Economic Co-operation and Development countries. Findings: Fifty-five concepts defined the research abstracts, of which only eight were policy-relevant, and six of which were minor research concepts. Conclusions The degree of disconnection between clinical concepts and healthcare system and workforce development concepts was striking. This study shows that, far from being “lost in translation,” oral health research and policy are so different as to raise doubts about the extent to which research is policy-relevant and policy is research-based. The notion of policy relevance encompasses the lack of willingness of policy makers to embrace research, and the need for researchers to develop research that is, and is seen to be, policy-relevant. PMID:25617516
Gen, Sheldon; Wright, Amy Conley
Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy capacity neglects the political aspects of policy-making that can dominate the process, even in health policies. These technical capabilities are certainly needed to advance reforms in health policies, but they are not sufficient. Instead, they must be complemented with public engagement and policy advocacy to ensure support from the public that policies are meant to serve. PMID:26673469
Full Text Available Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy capacity neglects the political aspects of policy-making that can dominate the process, even in health policies. These technical capabilities are certainly needed to advance reforms in health policies, but they are not sufficient. Instead, they must be complemented with public engagement and policy advocacy to ensure support from the public that policies are meant to serve.
... OFFICE Health Information Technology Policy Committee Vacancy AGENCY: Government Accountability Office... Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health IT...: HITCommittee@gao.gov . GAO: 441 G Street NW., Washington, DC 20548. FOR FURTHER INFORMATION CONTACT:...
Gardner, Karen; Davies, G Powell; Edwards, Karen; McDonald, Julie; Findlay, Terry; Kearns, Rachael; Joshi, Chandni; Harris, Mark
The aim of this systematic review was to assess evidence of the impact of commissioning on health service use, quality, outcomes and value for money and to consider findings in the Australian context. Systematic searches of the literature identified 444 papers and, after exclusions, 36 were subject to full review. The commissioning cycle (planning, contracting, monitoring) formed a framework for analysis and impacts were assessed at individual, subpopulation and population levels. Little evidence of the effectiveness of commissioning at any level was available and observed impacts were highly context-dependent. There was insufficient evidence to identify a preferred model. Lack of skills and capacity were cited as major barriers to the implementation of commissioning. Successful commissioning requires a clear policy framework of national and regional priorities that define agreed targets for commissioning agencies. Engagement of consumers and providers, especially physicians, was considered to be critically important but is time consuming and has proven difficult to sustain. Adequate information on the cost, volume and quality of healthcare services is critically important for setting priorities, and for contracting and monitoring performance. Lack of information resulted in serious problems. High-quality nationally standardised performance measures and data requirements need to be built into contracts and ongoing monitoring and evaluation. In Australia, there is significant work to be done in areas of policy and governance, funding systems and incentives, patient enrolment or registration, information systems, individual and organisational capacity, community engagement and experience in commissioning. PMID:27469052
Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.
Tang, Dave; Anderson, Denise; Francis, Richard W; Syn, Genevieve; Jamieson, Sarra E; Lassmann, Timo; Blackwell, Jenefer M
Genetic analyses, including genome-wide association studies and whole exome sequencing (WES), provide powerful tools for the analysis of complex and rare genetic diseases. To date there are no reference data for Aboriginal Australians to underpin the translation of health-based genomic research. Here we provide a catalogue of variants called after sequencing the exomes of 72 Aboriginal individuals to a depth of 20X coverage in ∼80% of the sequenced nucleotides. We determined 320,976 single nucleotide variants (SNVs) and 47,313 insertions/deletions using the Genome Analysis Toolkit. We had previously genotyped a subset of the Aboriginal individuals (70/72) using the Illumina Omni2.5 BeadChip platform and found ~99% concordance at overlapping sites, which suggests high quality genotyping. Finally, we compared our SNVs to six publicly available variant databases, such as dbSNP and the Exome Sequencing Project, and 70,115 of our SNVs did not overlap any of the single nucleotide polymorphic sites in all the databases. Our data set provides a useful reference point for genomic studies on Aboriginal Australians. PMID:27070114
Roos, Noralou P.; O'Grady, Kathleen; Singer, Sharon Manson; Turczak, Shannon; Tapp, Camilla
The media shape consumer expectations and interpretations of health interventions, influencing how people think about their need for care and the sustainability of the system. EvidenceNetwork.ca is a non-partisan, web-based project funded by the Canadian Institutes of Health Research and the Manitoba Health Research Council to make the latest evidence on controversial health policy issues available to the media. This website links journalists with health policy experts. We publish opinion pie...
Glass Deborah C
Full Text Available Abstract Background Since the 1991 Gulf War concerns have been raised about the effects of deployment to the Gulf War on veterans' health. Studies of the reproductive health of Gulf War veterans have reported varied findings. Methods We undertook a cross-sectional study of male Australian Gulf War veterans (n = 1,424 and a randomly sampled military comparison group (n = 1,548. The study was conducted from August 2000 to April 2002. A postal questionnaire included questions about difficulties achieving pregnancy, pregnancy outcomes including live births, stillbirths, miscarriages and terminations; and for all live births gestation, birth weight, sex, and any cancers, birth defects, chromosomal abnormalities or serious health problems. Results Male Gulf War veterans reported slightly increased risk of fertility difficulties following the Gulf War (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.0–1.8, but were more successful at subsequently fathering a child (OR 1.8; 95% CI 1.3–2.6. The study groups reported similar rates of pregnancies and live births. There was no increased risk in veterans of miscarriage, stillbirth, or terminations. Children of male Gulf War veterans born after the period of the Gulf War were not at greater risk of being born prematurely, having a low birth weight, or having a birth defect or chromosomal abnormality (OR 1.0; 95% CI 0.6–1.6. The numbers of cancers and deaths in children were too small to draw any firm conclusions. Conclusion The results of this study do not show an increased risk of adverse reproductive outcome in Australian male Gulf War veterans.
Oers, Johannes Anna Maria
textabstractThis book deals with the development and use of a geographic information system for local public health policy. Health differences between populations in different geographical areas, large (countries) or small (city-neighbourhoods) have always been a challenge to epidemiologists and policy makers. To epidemiologists, these differences can give insight into the health effects of certain exposures, for policy makers these differences can give rise to welltargeted interventions. Mak...
Ilana Halperin; Aliza Shupac; Mohammed Morad; Joav Merrick
Intellectual disability (ID) is a life-long disability characterized by impaired cognitive and adaptive skills. Over the past few decades, a shift has occurred in the conceptualization and treatment of people with ID and research in health policy and health-care delivery has become increasingly global with a notable disparity between the developed and developing world. This review presents a literature overview of global health policy for ID with the intent to focus specifically on the policy...
Denise de Azambuja Zocche
Full Text Available Report of a workshop on Women's Health Policy held in the third Critical Paths Seminar: extreme situations resulting from gender violence. The participants were ten women, three health students, four health professionals (nursing technician, psychologist, nurse and social worker, an educator and a lawyer. The methodology used was a debate about Women Public Policy and listening of music: Mariana went to the sea. By the end of the debate, we concluded that to understand and cope with the health needs of women who suffer violence is necessary to review not only the women health policy, but also health education and the work processes within the public safety sector.
Lixin Cai; Guyonne Kalb
The trend of declining labour force participation by older working-age men, combined with an ageing population, has led many industrialised nations to develop policies encouraging older male workers to remain in the labour force. A better understanding of how an individual’s health influences the labour force participation decision among this group of workers would facilitate the development of effective policies. The current research uses the Household, Income and Labour Dynamics in Australi...
Viney, Rosalie; Norman, Richard; Brazier, John; Cronin, Paula; King, Madeleine T; Ratcliffe, Julie; Street, Deborah
Conventionally, generic quality-of-life health states, defined within multi-attribute utility instruments, have been valued using a Standard Gamble or a Time Trade-Off. Both are grounded in expected utility theory but impose strong assumptions about the form of the utility function. Preference elicitation tasks for both are complicated, limiting the number of health states that each respondent can value and, therefore, that can be valued overall. The usual approach has been to value a set of the possible health states and impute values for the remainder. Discrete Choice Experiments (DCEs) offer an attractive alternative, allowing investigation of more flexible specifications of the utility function and greater coverage of the response surface. We designed a DCE to obtain values for EQ-5D health states and implemented it in an Australia-representative online panel (n = 1,031). A range of specifications investigating non-linear preferences with respect to time and interactions between EQ-5D levels were estimated using a random-effects probit model. The results provide empirical support for a flexible utility function, including at least some two-factor interactions. We then constructed a preference index such that full health and death were valued at 1 and 0, respectively, to provide a DCE-based algorithm for Australian cost-utility analyses. PMID:23765787
Full Text Available The problems confronted by people who experience mental disorders are often conceptualised in terms of health and illness. However, these problems extend far beyond the healthcare system, into all areas of human life. Having a psychiatric diagnosis may have a negative impact on every aspect of the individual’s life, leading to the deprivation or limitation of rights in relation to housing, employment, and family life. In this article, some of these problems are discussed within the theoretical framework of debates on citizenship and on human rights. As the context is Europe, reference is made to the recent policy initiatives with the EU, to national and European level consumer organisations and to cases brought before the European Court of Human Rights.
As teacher educators, we want our research to be influential in contributing to educational policy and practice, but there remains little understanding about ways in which teacher educators might more productively engage with each other and policy-makers so as to maximise their research impact. Drawing on an empirical study and policy document…
Whiteford, Chrystal; Walker, Sue; Berthelsen, Donna
This study examined the relationship between special health care needs and social-emotional and learning competence in the early years, reporting on two waves of data from the Kindergarten Cohort of "Growing up in Australia: The Longitudinal Study of Australian Children" (LSAC). Six hundred and fifty children were identified through the…
Morris, Suzanne E.
This paper provides a review of institutional authorship policies as required by the "Australian Code for the Responsible Conduct of Research" (the "Code") (National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC) & Universities Australia (UA) 2007), and assesses them for Code compliance. Institutional authorship…
Kelly Claire M; Kanowski Leonard G; Jorm Anthony F; Hart Laura M; Langlands Robyn L
Abstract Background Ethnic minority groups are under-represented in mental health care services because of barriers such as poor mental health literacy. In 2007, the Mental Health First Aid (MHFA) program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practic...
Whitford, Deirdre; Smith, Tony; Newbury, Jonathan
There is a lack of detailed evidence about the allied health workforce to inform proposed health care reforms. The South Australian Allied Health Workforce (SAAHW) survey collected data about the demographic characteristics, employment, education and recruitment and retention of allied health professionals in South Australia. The SAAHW questionnaire was widely distributed and 1539 responses were received. The average age of the sample was 40 years; males were significantly older than females, the latter making up 82% of respondents. Three-quarters of the sample worked in the city; 60% worked full time and the remainder in part-time, casual or locum positions. 'Work-life balance' was the most common attraction to respondents' current jobs and 'Better career prospects' the most common reason for intending to leave. Practice in a rural location was influenced by rural background and rural experience during training. A greater proportion of Generation Y (1982-2000) respondents intended to leave within 2 years than Generation X (1961-81) or Baby Boomers (1943-60). Most respondents were satisfied with their job, although some reported lack of recognition of their knowledge and skills. Systematic, robust allied health workforce data are required for integrated and sustainable primary health care delivery. PMID:23069367
Full Text Available Abstract Background With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. Methods The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. Results With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010. This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA; action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs, and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames
Petersen, Poul Erik
promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject to......The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past five years to increase the awareness of oral health worldwide as an important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income...... countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and the necessary actions for the improvement of oral health. The strategy is that oral disease prevention and the...
Katrina D Hopkins
Full Text Available Psychosocial processes are implicated as mediators of racial/ethnic health disparities via dysregulation of physiological responses to stress. Our aim was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on Aboriginal youths' psychosocial functioning were similarly beneficial for their physical health status.We examined the relationship between psychosocial resilience and physical health of urban Aboriginal youth (12-17 years, n = 677 drawn from a representative survey of Western Australian Aboriginal children and their families. A composite variable of psychosocial resilient status, derived by cross-classifying youth by high/low family risk exposure and normal/abnormal psychosocial functioning, resulted in four groups- Resilient, Less Resilient, Expected Good and Vulnerable. Separate logistic regression modeling for high and low risk exposed youth revealed that Resilient youth were significantly more likely to have lower self-reported asthma symptoms (OR 3.48, p<.001 and carer reported lifetime health problems (OR 1.76, p<.04 than Less Resilient youth.The findings are consistent with biopsychosocial models and provide a more nuanced understanding of the patterns of risks, resources and adaptation that impact on the physical health of Aboriginal youth. The results support the posited biological pathways between chronic stress and physical health, and identify the protective role of social connections impacting not only psychosocial function but also physical health. Using a resilience framework may identify potent protective factors otherwise undetected in aggregated analyses, offering important insights to augment general public health prevention strategies.
Grundy, John; Hoban, Elizabeth; Allender, Steve; Annear, Peter
One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own
Full Text Available Drug policies affect a large set of outcomes and may reflect the concerns of several policy stakeholder groups. Researchers analysing policies typically employ a public health approach, extended to reflect concerns beyond population health and longevity. I argue that the resulting approach, as currently practised, fails to capture several concerns seen as important by recent drug policy reform movements, that is, the full harms of illegal markets, the subjectively valued consumption of intoxicants, the dysfunctionality of current policy processes in the drug field and the value of the knowledge gained from policy experiments. I illustrate this by referring to the book Drug policy and the public good, a public health-based review of research evidence and its relevance for drug policy written by leading international researchers in the field.
During 2006 and 2007 the Australian Nuclear Science and Technology Organisation (ANSTO) commissioned OPAL, a 20 MW open pool Research Reactor. This commissioning involved three stages; Stage A, testing the reactors systems prior to fuel loading, Stage B, first loading of fuel, achieving first criticality, reactor characterisation and systems testing up to 400kW, and Stage C, raising the power of the reactor in steps, up to its full operating power of 20MW. Prior to and following fuel loading a series of radiation measurements were made throughout the plant. These included dose rates, radioactivity in air, on surfaces and in cooling and shielding liquids. Installed continuous monitoring and portable equipment were used. Health physics measurements were repeated at increasing reactor power levels to check engineering design features and design of plant for radiation protection aspects. A Radiation Protection Plan and associated monitoring programs were implemented, including establishing and maintaining area, task and personnel monitoring regimes in the facility. Health Physics assessments and advice at each stage, played a major role in this commissioning process. This paper discusses the health physics experience of commissioning the OPAL Research Reactor and describes health physics results, actions taken and lessons learned during commissioning. (author)
During 2006 and 2007 the Australian Nuclear Science and Technology Organisation (ANSTO) commissioned OPAL, a 20 MW open pool Research Reactor. This commissioning involved three stages: Stage A: testing the reactors systems prior to fuel loading; Stage B: first loading of fuel, achieving first criticality, reactor characterisation and systems testing up to 400 kw; and Stage C: raising the power of the reactor in steps, up to its full operating power of 20 MW. Prior to and following fuel loading a series of radiation measurements were made throughout the plant. These included dose rates, radioactivity in air, on surfaces and in cooling and shielding liquids. Installed continuous monitoring and portable equipment were used. Health physics measurements were repeated at increasing reactor power levels to check engineering design features and design of plant for radiation protection aspects. A Radiation Protection Plan and associated monitoring programs were implemented, including establishing and maintaining area, task and personnel monitoring regimes in the facility. Health Physics assessments and advice at each stage, played a major role in this commissioning process. This paper discusses the health physics experience of commissioning the OPAL Research Reactor and describes health physics results, actions taken and lessons learned during commissioning. (author)
Gary J Fooks
Full Text Available BACKGROUND: The Framework Convention of Tobacco Control (FCTC provides a basis for nation states to limit the political effects of tobacco industry philanthropy, yet progress in this area is limited. This paper aims to integrate the findings of previous studies on tobacco industry philanthropy with a new analysis of British American Tobacco's (BAT record of charitable giving to develop a general model of corporate political philanthropy that can be used to facilitate implementation of the FCTC. METHOD: Analysis of previously confidential industry documents, BAT social and stakeholder dialogue reports, and existing tobacco industry document studies on philanthropy. RESULTS: The analysis identified six broad ways in which tobacco companies have used philanthropy politically: developing constituencies to build support for policy positions and generate third party advocacy; weakening opposing political constituencies; facilitating access and building relationships with policymakers; creating direct leverage with policymakers by providing financial subsidies to specific projects; enhancing the donor's status as a source of credible information; and shaping the tobacco control agenda by shifting thinking on the importance of regulating the market environment for tobacco and the relative risks of smoking for population health. Contemporary BAT social and stakeholder reports contain numerous examples of charitable donations that are likely to be designed to shape the tobacco control agenda, secure access and build constituencies. CONCLUSIONS AND RECOMMENDATIONS: Tobacco companies' political use of charitable donations underlines the need for tobacco industry philanthropy to be restricted via full implementation of Articles 5.3 and 13 of the FCTC. The model of tobacco industry philanthropy developed in this study can be used by public health advocates to press for implementation of the FCTC and provides a basis for analysing the political effects of
Full Text Available Susan A NancarrowSchool of Health and Human Sciences, Southern Cross University, East Lismore, NSW, AustraliaAbstract: For over a decade, organizations have attempted to include the measurement and reporting of health outcome data in contractual agreements between funders and health service providers, but few have succeeded. This research explores the utility of collecting health outcomes data that could be included in funding contracts for an Australian Community Care Organisation (CCO. An action-research methodology was used to trial the implementation of outcome measurement in six diverse projects within the CCO using a taxonomy of interventions based on the International Classification of Function. The findings from the six projects are presented as vignettes to illustrate the issues around the routine collection of health outcomes in each case. Data collection and analyses were structured around Donabedian's structure–process–outcome triad. Health outcomes are commonly defined as a change in health status that is attributable to an intervention. This definition assumes that a change in health status can be defined and measured objectively; the intervention can be defined; the change in health status is attributable to the intervention; and that the health outcomes data are accessible. This study found flaws with all of these assumptions that seriously undermine the ability of community-based organizations to introduce routine health outcome measurement. Challenges were identified across all stages of the Donabedian triad, including poor adherence to minimum dataset requirements; difficulties standardizing processes or defining interventions; low rates of use of outcome tools; lack of value of the tools to the service provider; difficulties defining or identifying the end point of an intervention; technical and ethical barriers to accessing data; a lack of standardized processes; and time lags for the collection of data. In no case was
Hanggoro Pamungkas; Maya Safira Dewi; Yunita Anwar; Martin Surya Mulyadi
Tax policy is one of the most important policy in consideration of investment development in certain industry. Research by Newlon (1987), Swenson (1994) and Hines (1996) concluded that tax rate is one of the most important thing considered by investors in a foreign direct investment. One of tax policy could be used to attract foreign direct investment is income tax incentives. The attractiveness of income tax incentives to a foreign direct investment is as much as the attractiveness to a dome...
Cairney Sheree J; Gunthorpe Wendy; Paradies Yin C; Jamieson Lisa M; Sayers Susan M
Abstract Background Social and emotional well-being is an important component of overall health. In the Indigenous Australian context, risk indicators of poor social and emotional well-being include social determinants such as poor education, employment, income and housing as well as substance use, racial discrimination and cultural knowledge. This study sought to investigate associations between oral health-related factors and social and emotional well-being in a birth cohort of young Aborig...
Brandt, Heather M; Pierce, Jennifer Young; Crary, Ashley
Vaccines against specific types of human papillomavirus (HPV) linked to cancer and other diseases have been met with mixed acceptance globally and in the United States. Policy-level interventions have been shown to be effective in increasing public health benefit. Government policies and mandates may result in improved HPV vaccination coverage and reduced disease burden, and alternative policies that improve unhindered access to HPV vaccination may allow success as well. The purpose of this commentary is to summarize policy efforts to maximize the public health benefit of HPV vaccination. We examine selected examples of HPV vaccination policy in global contexts and in the United States. PMID:26669416
Perry, Lin; Gallagher, Robyn; Duffield, Christine
Background Nurses make up the largest component of the health workforce and provide the majority of patient care. Most health education is delivered by nurses, who also serve as healthy living and behavioural role models. Anything that diminishes their health status can impact their credibility as role models, their availability and ability to deliver quality care, and is potentially disadvantageous for the health of the population. Study aims were to investigate nurses’ overall health and th...
... OFFICE Health Information Technology Policy Committee Nomination Letters AGENCY: Government... Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee...: HITCommittee@gao.gov ; GAO: 441 G Street NW., Washington, DC 20548. FOR MORE INFORMATION CONTACT: GAO:...
Aliyu Zakari Y
Full Text Available Abstract Background The number of potential life years lost due to accidents and injuries though poorly studied has resulted in tremendous economic and social loss to Nigeria. Numerous socio-cultural, economic and political factors including the current epidemic of ethnic and religious conflicts act in concert in predisposing to and enabling the ongoing catastrophe of accident and injuries in Nigeria. Methods Using the "policymaker", Microsoft-Windows® based software, the information generated on accidents and injuries and emergency health care in Nigeria from literature review, content analysis of relevant documents, expert interviewing and consensus opinion, a model National Emergency Health Policy was designed and analyzed. A major point of analysis for the policy is the current political feasibility of the policy including its opportunities and obstacles in the country. Results A model National Emergency Health Policy with policy goals, objectives, programs and evaluation benchmarks was generated. Critical analyses of potential policy problems, associated multiple players, diverging interests and implementation guidelines were developed. Conclusions "Political health modeling" a term proposed here would be invaluable to policy makers and scholars in developing countries in assessing the political feasibility of policy managing. Political modeling applied to the development of a NEHP in Nigeria would empower policy makers and the policy making process and would ensure a sustainable emergency health policy in Nigeria.
Vines, Tim; Crow, Kim; Faunce, Thomas
Over the past year, several significant reforms to Australia's intellectual property regime have been proposed and passed by Parliament. The Intellectual Property Laws Amendment (Raising the Bar) Act 2012 (Cth) made various improvements to Australian patent law, including an improved threshold for patentability, greater clarity around "usefulness" requirements, and the introduction of an experimental use exemption from infringement. Another Bill, the Intellectual Property Laws Amendment Bill 2012 (Cth), currently out for public consultation, would implement a 2003 decision of the World Trade Organisation (WTO) General Council and the 2005 Doha Declaration on the TRIPS Agreement and Public Health (Doha Declaration). If enacted, this Bill would facilitate equitable access to essential medicines by amending the compulsory licensing regime set out in the Patents Act 1990 (Cth). The underlying intention of this Bill--meeting public health goals outlined in the 2005 Doha Declaration--stands in juxtaposition to proposed reforms to intellectual property standards pursuant to the Trans-Pacific Partnership Trade and Investment Agreement (TPPA) that Australia is involved in. Although at a preliminary stage, leaked drafts of relevant intellectual property provisions in the TPPA suggest a privileging of patent monopoly privileges over public health goals. This column weighs the sentiments of the proposed Bill against those of the proposed provisions in the TPPA. PMID:23431847
Full Text Available Rapid developments in ICT are extending and transforming the ways public services are delivered to citizens. The area of public healthcare has always been viewed as particularly as information intensive. This phenomenon is made more complex by rapid changes and continual increases in technological capability as well as increasing demands for new functions by users. Therefore, when conducting research in this area it is essential to take a holistic approach that integrates the latest ICT tools and processes with the needs of individuals. Q methodology is a research design that provides a foundation for the systematic study of subjectivity. The use of Q in the dynamic health context, we propose, is appropriate as a way of fostering deeper understandings of online public health phenomena. This paper reports on the results of a subjective study of the usefulness and usability of online public health information systems. The study used Q-methodology to investigate the perceptions of an Australian palliative care website with a group of available potential users of the website, which was composed of medical practitioners and students, and the general public, mostly from the computer-literate academic community. The most significant finding of this subjective study of internet-literate participants’ perceptions towards online palliative care is the recognition of four groups: interactive, superficial, medical and service.
The Labor government in Australia has recently embarked on an extremely ambitious program of social inclusion for the most marginalized groups in society. Drawing upon the approach of "policy scholarship" this paper examines some federal government "policy texts" to describe what has occurred and asks questions about what is meant by the social…
Full Text Available Pierre-Gerlier Forest and his colleagues make a strong argument for the need to expand policy capacity among healthcare actors. In this commentary, I develop an additional argument in support of Forest et al view. Forest et al rightly point to the need to have embedded policy experts to successfully translate healthcare reform policy into healthcare change. Translation of externally generated innovation policy into local solutions is only one source of healthcare system change. We also need to build learning healthcare systems that can discover new health solutions at the frontline of care. Enhanced policy capacity staffing in those organizations will be key to building continuously learning health systems.
Full Text Available Abstract Background Frequent illness and injury among workers with high body mass index (BMI can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. Methods Personnel were grouped into cohorts according to the following ranges for (BMI: normal (18.5 − 24.9 kg/m2; n = 197, overweight (25–29.9 kg/m2; n = 154 and obese (≥30 kg/m2 with restricted body fat (≤28% for females, ≤24% for males (n = 148 and with no restriction on body fat (n = 180. Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions and administrative outcomes (e.g., discharge from service over one year. These data were then grouped and compared between the cohorts. Results The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p Conclusions High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.
MacDougall, Colin; Gibbs, Lisa; Clark, Rachel
The Victorian Country Fire Authority in Australia runs the Community Fireguard (CFG) programme to assist individuals and communities in preparing for fire. The objective of this qualitative research was to understand the impact of CFG groups on their members' fire preparedness and response during the 2009 Australian bushfires. Social connectedness emerged as a strong theme, leading to an analysis of data using social capital theory. The main strength of the CFG programme was that it was driven by innovative community members; however, concerns arose regarding the extent to which the programme covered all vulnerable areas, which led the research team to explore the theory of diffusion of innovation. The article concludes by stepping back from the evaluation and using both applied theories to reflect on broad options for community fire preparedness programmes in general. The exercise produced two contrasting options for principles underlying community fire preparedness programmes. PMID:24601916
Full Text Available In 1985 the Australian Government sought to delete circumcision of infants from the benefits payable under its newly established universal health scheme, Medicare. Although the decision had been recommended by the government's health advisers and was welcomed by medical authorities, it was soon reversed after protests from Jewish community leaders. I present a detailed narrative of this affair and explain why a decision based on sound medical knowledge advice was rescinded after quite mild objections. The answer is found to lie partly in contingent factors, such as the details of the policy change, the personalities of the government figures involved, and problems with implementation and communication; and partly in the sensibilities of the ethnic/religious communities most directly affected. I dispel the misconception that the original decision aroused widespread opposition and show, on the contrary, that it was based on good advice, represented sound public policy, and was widely supported. I conclude that the episode may have useful lessons for other governments seeking to implement or resist policy changes that affect the sensitivities of cultural minorities.
Baum, Fran; Lawless, Angela; MacDougall, Colin; Delany, Toni; McDermott, Dennis; Harris, Elizabeth; Williams, Carmel
Health systems have long been criticised for focussing on curing rather than preventing disease. This paper examines to what extent the Adelaide Thinkers in Residence (ATiR) scheme contributed to the change in norms whereby promoting well-being and a strategy to achieve this - Health in All Policies (HiAP)--was adopted by the South Australian (SA) State Government from 2007. The data presented in this paper are drawn from a five year (2012-2016) detailed mixed methods case study of the SA HiAP initiative which involved document analysis, interviews and workshops with public servants and political actors. We adapt the framework used by Finnemore and Sikkink (1998) which explains how norm changes can lead to political changes in international affairs. We also use Kingdon's concept of policy entrepreneurs to determine whether these ideas moved to an implementable initiative with the help of both a specific ATiR program on HiAP and the broader TiR scheme which promoted a series of innovations relevant to health. The process involved the ATiR reinforcing the work of local norm entrepreneurs with that of powerful external policy entrepreneurs, adapting the discourse about the value of prevention and promoting well-being so that it fitted with the dominant economic one. The powerful organisational platform of the ATiR, which was under the Department of the Premier and Cabinet and linked to the South Australian Strategic Plan (SASP) was used to advance these ideas. The case study offers important lessons for other jurisdictions on how to shift policy to encourage intersectoral approaches to health. PMID:26520058
Buykx Penny; Kinsman Leigh; Humphreys John S; Tham Rachel; Asaid Adel; Tuohey Kathy
Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations ...
Full Text Available Abstract Background Mental health policy is needed to set the strategy and direction for the provision of mental health services in a country. Policy formulation does not occur in a vacuum, however, but is influenced by local and international factors in the health sector and other sectors. Methods This study was carried out in 1997 to examine the evolution of mental health policy in Kenya between 1965 and 1997 in the context of changing international concepts of health and development. Qualitative content analysis of policy documents was combined with interviews of key policy makers. Results The study showed that during the period 1965-1997 the generic health policy in Kenya changed from one based on the Medical Model in the 1960s and 1970s to one based on the Primary Health Care Model in the late 1970s and the 1980s and finally to one based on the Market Model of health care in the 1990s. The mental health policy, on the other hand, evolved from one based on the Medical Model in the 1960s to one based on the Primary Health Care Model in the 1990s, but did not embrace the Market Model of health care. This resulted in a situation in the 1990s where the mental health policy was rooted in a different conceptual model from that of the generic health policy under which it was supposed to be implemented. This "Model Muddlement" may have impeded the implementation of the mental health policy in Kenya. Conclusions Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway.
Full text: In an age of clearly needing to address climate change and reduce greenhouse gas emissions, nuclear energy has the advantage of being a low-carbon emission technology for electricity generation. Although there are many other low-carbon technologies, the Australian federal government has publicly favoured the development of a nuclear power industry in light of these climate change concerns. The starting point for assessing whether nuclear power should be part of Australia's response to climate change is purely on economic grounds. To examine nuclear economic viability, the Prime Minister initiated a Uranium Mining, Processing and Nuclear Energy Review (UMPNER), which published its findings in December 2006. The UMPNER review concluded that nuclear energy is the 'least cost low-emission baseload technology option' and could lead to a viable nuclear power industry of up to 25 reactors by 2050 for Australia. Accurate economic cost estimates are vitally important in the current debate over which low emission generation technologies to prioritise for supplying Australia's future increasing energy demand. The UMPNER review did not conduct a new analysis into the economics of nuclear power, but rather reviews cost estimates from particular international studies. Part of this presentation will draw upon other recent international experience and evidence to re-evaluate the reliability of nuclear economic cost estimates for Australia. The presentation will follow on to discuss some unique Australian constraints and whether the introduction of a carbon price signal will be enough to overcome some major hurdles in introducing nuclear power as a response to climate change in Australia