Public relations and ontology: rhetorical approaches in post-modern times

Rhetorical theory's contemporary involvement with semiotics is overlooked in much current public relations scholarship. This paper aims to 'make a difference' in this respect. There is a need for this change of perspective in view of a call for a new direction in public relations theory. This call came in the final Public Relations Division session at the July, 2003 International Communication Association Convention in San Diego. That panel discussion was titled: 'What Should be the Focus of Public Relations?' The session concluded that a turn towards 'rhetorical theory' was needed. This paper argues that such a turn would pose interesting theoretical and political challenges for a field which has not fully caught up with post-modern ideas. It points out how involvement with the contemporary 'rhetorical turn' paradigm and this paradigm's link to semiotics, would take public relations studies into interesting conceptual and political regions.

Service failure and recovery in the presence of service guarantees

This paper presents a conceptual model and propositions outlining how, in a service recovery encounter, service guarantees (unconditional and specific) operate in conjunction with other organisational recovery variables (guarantee facilitation and service provider concern), to influence customers’ justice perceptions and subsequent satisfaction evaluations.

The employee share ownership plan: what value has it for Australia?

The Australian government is currently committed to the goal of increasing organisational participation in employee share ownership plans (ESOP) from 4% of all companies to 11% by 2009. The Nelson Report into ESOPs commissioned by the Honourable Brendan Nelson highlighted the lack of comprehensive information on the nature and extent of ESO plans in Australia. ” (Nelson 2000). This paper places the program in context by reviewing overseas experiences and considers the viewpoints of both employers and employees. The preliminary investigation concludes by highlighting the need for further thorough research before success for all types of businesses can be confidently predicted. ”

Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression

Objective: Antidepressant drugs and cognitive–behavioural therapy (CBT) are effective treatment options for depression and are recommended by clinical practice guidelines. As part of the Assessing Cost-effectiveness – Mental Health project we evaluate the available evidence on costs and benefits of CBT and drugs in the episodic and maintenance treatment of major depression.

Method: The cost-effectiveness is modelled from a health-care perspective as the cost per disability-adjusted life year. Interventions are targeted at people with major depression who currently seek care but receive non-evidence based treatment. Uncertainty in model inputs is tested using Monte Carlo simulation methods.

Results: All interventions for major depression examined have a favourable incremental cost-effectiveness ratio under Australian health service conditions. Bibliotherapy, group CBT, individual CBT by a psychologist on a public salary and tricyclic antidepressants (TCAs) are very cost-effective treatment options falling below $A10 000 per disability-adjusted life year (DALY) even when taking the upper limit of the uncertainty interval into account. Maintenance treatment with selective serotonin re-uptake inhibitors (SSRIs) is the most expensive option (ranging from $A17 000 to $A20 000 per DALY) but still well below $A50 000, which is considered the affordable threshold.

Conclusions: A range of cost-effective interventions for episodes of major depression exists and is currently underutilized. Maintenance treatment strategies are required to significantly reduce the burden of depression, but the cost of long-term drug treatment for the large number of depressed people is high if SSRIs are the drug of choice. Key policy issues with regard to expanded provision of CBT concern the availability of suitably trained providers and the funding mechanisms for therapy in primary care.

Workforce trends in specialist and GP obstetric practice in Victoria

OBJECTIVE: To provide a contemporary picture of the general practitioner and specialist obstetric workforce in Victoria.

DESIGN, PARTICIPANTS AND SETTING: Postal census by questionnaire of all 317 Fellows and 961 Diplomates on the Victorian database of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in September 2003.

MAIN OUTCOME MEASURES: Sex, age and geographical distributions and patterns of retirement from and recruitment to the GP and specialist obstetric workforce in Victoria.

RESULTS: 244 Fellows (77.0%) and 652 Diplomates (67.8%) participated. The average age of Diplomates was 42 years; only 20% were involved in procedural obstetrics. Of GPs practising procedural obstetrics, 56% intended to cease within 7 years. Two-thirds of specialist obstetricians continued to practise obstetrics. Among those ceasing obstetrics, almost half had done so since 2000. Among Fellows ceasing obstetric practice, there is a peak in the 50-60-years age group, but cessation of obstetric practice occurred across all age groups.

CONCLUSION: The proportion of GPs involved in procedural obstetrics has fallen markedly over the past decade, with half of those ceasing practice in the 40-50-years age group. New GPs entering the workforce with the Diploma and overseas doctors are unlikely to meet the procedural workforce shortfall. Attracting the large cohort of doctors aged 40-50 years back to obstetric practice must be a priority. Given the pattern of retirements from obstetrics, there will be insufficient numbers of specialists to maintain current levels of service. The reasons include non-participation in obstetrics by new graduates and international medical graduates, the inadequate number of new graduates, and the predominance of women among specialists aged under 40 years, whose work output tends to be affected by family commitments.

Mandatory fortification with folic acid: what would hippocrates say?

In October 2006, the Australian and New Zealand Food Regulation Ministerial Council asked for a review of the proposed food standard permitting mandatory fortification of bread with folic acid. This article contributes to the policy debate associated with the standard’s review by discussing the potential benefits and risks to the target population and the wider Australian population with emphasis on recent (2006) literature.

Does the Triple P-Positive Parenting Program provide value for money?

Objective: The aim of the present study was to investigate the economic case for the implementation of the Triple P-Positive Parenting Program on a population basis in Queensland, Australia, in order to reduce the prevalence of conduct disorder in children. Method: Threshold analysis was undertaken together with a limited cost-effectiveness analysis. Results: The Triple P-Positive Parenting Program is a dominant intervention; that is, it costs less than the amount it saves, until the reduction in prevalence falls below 7% where net costs become positive. Conclusions: Triple P is likely to be a worthwhile use of limited health funds. The economic case is promising, but further research is required to confirm the study results.

Framing the discourses of harm and loss: a case study of power relations, mobile phones, and children in Australia

The current penetration of mobile phones in Australia is 92% and it records one of the world’s highest rates of ownership among children under 18. The paper reviews the literature on mobile phones and Australian children and examines the various discourses dominating the public debates; the systematic frames used in these discourses; and whose interests are served in the process. The frames discussed fall under the optimistic (gains); pessimistic (losses, costs or harms); pluralistic (technology per se is neutral but how it is used matters); historical development (skills learnt and the importance of using mobiles); futuristic predictions (promises and dangers for the future); current uses (connectivity, convergence and interactivity); and the techno-realist view (as a mixed blessing) views of technology. Taking the critical perspective and borrowing from Joshua Meyrowitz, the paper illustrates how mobile phones have eroded parental power over how, when, where and with whom their children communicate, surpassing adult supervision, intervention or knowledge, while at the same time, becoming a ‘digital leash’ for parents to re-establish their control an d an ‘umbilical cord’ for their off spring to remain connect! ed with parents, at all times.

Facts on fats

Cardiovascular disease and age-related macular degeneration (AMD) may share common risk factors in their causal pathways. Decades of research from the cardiovascular sciences on fats have led investigators to focus on specific types of fats rather than total fat as a whole. They have established that saturated and trans-unsaturated fats (trans fats) are damaging to cardiovascular health while polyunsaturated fats, particularly the marine omega 3 fatty acids appear protective. This has led to a number of studies investigating the associations of fat and AMD. Though the causal relationship between fats and AMD remain unproven, some studies suggest that an association may be present. To be able to understand and interpret the study results and their implications, an understanding of the fats in the diet is important. This review aims to give an overview of fatty acids, particularly the trans-unsaturated fatty acids, and the relevant food groups.

Assessing cost-effectiveness in mental health : vocational rehabilitation for schizophrenia and related conditions

Objective: Existing evidence suggests that vocational rehabilitation services, in particular individual placement and support (IPS), are effective in assisting people with schizophrenia and related conditions gain open employment. Despite this, such services are not available to all unemployed people with schizophrenia who wish to work. Existing evidence suggests that while IPS confers no clinical advantages over routine care, it does improve the proportion of people returning to employment. The objective of the current study is to investigate the net benefit of introducing IPS services into current mental health services in Australia.

Method: The net benefit of IPS is assessed from a health sector perspective using cost–benefit analysis. A two-stage approach is taken to the assessment of benefit. The first stage involves a quantitative analysis of the net benefit, defined as the benefits of IPS (comprising transfer payments averted, income tax accrued and individual income earned) minus the costs. The second stage involves application of 'second-filter' criteria (including equity, strength of evidence, feasibility and acceptability to stakeholders) to results. The robustness of results is tested using the multivariate probabilistic sensitivity analysis.

Results: The costs of IPS are $A10.3M (95% uncertainty interval $A7.4M–$A13.6M), the benefits are $A4.7M ($A3.1M–$A6.5M), resulting in a negative net benefit of $A5.6M ($A8.4M–$A3.4M).

Conclusions: The current analysis suggests that IPS costs are greater than the monetary benefits. However, the evidence-base of the current analysis is weak. Structural conditions surrounding welfare payments in Australia create disincentives to full-time employment for people with disabilities.