Searching for value : the influence of policy and reform on nurses’ sense of value in long-term aged care in Australia.

Contemporary literature on long-term aged care focuses heavily on issues associated with the recruitment and retention of nursing staff, such as job satisfaction and attitudes towards caring for older people. This paper aims to highlight one aspect of a larger study of registered nurses' experiences in long-term aged care in Australia and the influence that government policy and reform has in shaping that experience. This insight into aspects of nurses' everyday experience also contributes to a broader understanding of job satisfaction in long-term care. Findings from this study suggest that registered nurses experience tension in their search for value in their practice, which incorporates professional, political and social mediators of value and worth. These issues are discussed in relation to the impact of policy and reform on nurses' sense of value in long-term aged care and highlight the need for sensitive policy initiatives that support issues of value in nursing practice.

Promoting a more positive traffic safety culture in Australia : lessons learnt and future directions

Adopting a traffic safety culture approach, this paper identifies and discusses the ongoing challenge of promoting the road safety message in Australia. It is widely acknowledged that mass media and public education initiatives have played a critical role in the significant positive changes witnessed in community attitudes to road safety in the last three to four decades. It could be argued that mass media and education have had a direct influence on behaviours and attitudes, as well as an indirect influence through signposting and awareness raising functions in conjunction with enforcement. Great achievements have been made in reducing fatalities on Australia’s roads; a concept which is well understood among the international road safety fraternity. How well these achievements are appreciated by the general Australian community however, is not clear. This paper explores the lessons that can be learnt from successes in attitudinal and behaviour change in regard to seatbelt use and drink driving in Australia. It also identifies and discusses key challenges associated with achieving further positive changes in community attitudes and behaviours, particularly in relation to behaviours that may not be perceived by the community as dangerous, such as speeding and mobile phone use while driving. Potential strategies for future mass media and public education campaigns to target these challenges are suggested, including ways of harnessing the power of contemporary traffic law enforcement techniques, such as point-to-point speed enforcement and in-vehicle technologies, to help spread the road safety message.

Emergency Health Services (EHS) : demand and service delivery models. monograph 3 : patients’ reasons and perceptions

Executive Summary Emergency health is a critical component of Australia’s health system and emergency departments (EDs) are increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the perspectives of users of both ambulance services and EDs. The research reported here aimed to identify the perspectives of users of emergency health services, both ambulance services and public hospital Emergency Departments and to identify the factors that they took into consideration when exercising their choice of location for acute health care. A cross-sectional survey design was used involving a survey of patients or their carers presenting to the EDs of a stratified sample of eight hospitals. A specific purpose questionnaire was developed based on a novel theoretical model which had been derived from analysis of the literature (Monograph 1). Two survey versions were developed: one for adult patients (self-complete); and one for children (to be completed by parents/guardians). The questionnaires measured perceptions of social support, health status, illness severity, self-efficacy; beliefs and attitudes towards ED and ambulance services; reasons for using these services, and actions taken prior to the service request. The survey was conducted at a stratified sample of eight hospitals representing major cities (four), inner regional (two) and outer regional and remote (two). Due to practical limitations, data were collected for ambulance and ED users within hospital EDs, while patients were waiting for or under treatment. A sample size quota was determined for each ED based on their 2009/10 presentation volumes. The data collection was conducted by four members of the research team and a group of eight interviewers between March and May 2011 (corresponding to autumn season). Of the total of 1608 patients in all eight emergency departments the interviewers were able to approach 1361 (85%) patients and seek their consent to participate in the study. In total, 911 valid surveys were available for analysis (response rate= 67%). These studies demonstrate that patients elected to attend hospital EDs in a considered fashion after weighing up alternatives and there is no evidence of deliberate or ill-informed misuse. • Patients attending ED have high levels of social support and self-efficacy that speak to the considered and purposeful nature of the exercise of choice. • About one third of patients have new conditions while two thirds have chronic illnesses • More than half the attendees (53.1%) had consulted a healthcare professional prior to making the decision. • The decision to seek urgent care at an ED was mostly constructed around the patient’s perception of the urgency and severity of their illness, reinforced by a strong perception that the hospital ED was the correct location for them (better specialised staff, better care for my condition, other options not as suitable). • 33% of the respondent held private hospital insurance but nevertheless attended a public hospital ED. Similarly patients exercised considered and rational judgements in their choice to seek help from the ambulance service. • The decision to call for ambulance assistance was based on a strong perception about the severity of the illness (too severe to use other means of transport) and that other options were not considered appropriate. • The decision also appeared influenced by a perception that the ambulance provided appropriate access to the ED which was considered most appropriate for their particular condition (too severe to go elsewhere, all facilities in one spot, better specialised and better care). • In 43.8% of cases a health care professional advised use of the ambulance. • Only a small number of people perceived that ambulance should be freely available regardless of severity or appropriateness. These findings confirm a growing understanding that the choice of professional emergency health care services is not made lightly but rather made by reasonable people exercising a judgement which is influenced by public awareness of the risks of acute health and which is most often informed by health professionals. It is also made on the basis of a rational weighing up of alternatives and a deliberate and considered choice to seek assistance from a service which the patient perceived was most appropriate to their needs at that time. These findings add weight to dispensing with public perceptions that ED and ambulance congestion is a result of inappropriate choice by patients. The challenge for health services is to better understand the patient’s needs and to design and validate services that meet those needs. The failure of our health system to do so should not be grounds for blaming the patient, claiming inappropriate patient choices.

Exploring the influences of country-level factors on mid-age women’s drink driving attitudes

Drink driving remains a major cause of serious and fatal car crashes in Australia and internationally. While this problem is more prevalent among male drivers, the rates of female intoxicated drivers have increased steadily over the past decades in many motorised countries. A combination of police enforcement, media awareness campaigns, and community initiatives has played a key role in reducing incidents of illegal drink driving by targeting public drink driving attitudes. However, important cultural differences in regards to the tolerance towards drink driving have been noted. While many countries, including Australia, have a legal Blood Alcohol Concentration (BAC) limit of .05 or higher, some countries have moved towards a zero –or low tolerance approach to drink driving; several European countries, including Sweden, Hungary, Slovakia, and Estonia currently enforce .00 or .02 BAC limits.

Implementation of a better choice healthy food and drink supply strategy for staff and visitors in government owned health facilities in Queensland, Australia

Objective The present paper reports on a quality improvement activity examining implementation of A Better Choice Healthy Food and Drink Supply Strategy for Queensland Health Facilities (A Better Choice). A Better Choice is a policy to increase supply and promotion of healthy foods and drinks and decrease supply and promotion of energy-dense, nutrient-poor choices in all food supply areas including food outlets, staff dining rooms, vending machines, tea trolleys, coffee carts, leased premises, catering, fundraising, promotion and advertising. Design An online survey targeted 278 facility managers to collect self-reported quantitative and qualitative data. Telephone interviews were sought concurrently with the twenty-five A Better Choice district contact officers to gather qualitative information. Setting Public sector-owned and -operated health facilities in Queensland, Australia. Subjects One hundred and thirty-four facility managers and twenty-four district contact officers participated with response rates of 48·2 % and 96·0 %, respectively. Results Of facility managers, 78·4 % reported implementation of more than half of the A Better Choice requirements including 24·6 % who reported full strategy implementation. Reported implementation was highest in food outlets, staff dining rooms, tea trolleys, coffee carts, internal catering and drink vending machines. Reported implementation was more problematic in snack vending machines, external catering, leased premises and fundraising. Conclusions Despite methodological challenges, the study suggests that policy approaches to improve the food and drink supply can be implemented successfully in public-sector health facilities, although results can be limited in some areas. A Better Choice may provide a model for improving food supply in other health and workplace settings.

Investigating attitudes towards three South American destinations in an emerging long haul market using a model of consumer-based brand equity (CBBE)

Despite the importance of destination image in market competitiveness, and the popularity of the field within tourism literature, there remains a dearth of published research examining travellers’ perceptions of destinations in South America. This manuscript addresses this gap by testing a model of consumer-based brand equity (CBBE) associated with three South American countries; Chile, Brazil and Argentina. The introduction of direct air links and a free trade agreement in 2008 has led destination marketing organisations (DMOs) in these countries to increase promotional efforts in the Australian market. This study shows that the CBBE model is an appropriate tool to explore consumers’ attitudes in the long haul travel context. The findings provide DMOs of the three countries studied, with benchmarks against which to compare the impact of future marketing communications in Australia. The results provide increased transparency and accountability to stakeholders, such as South American tourism businesses and Australian travel intermediaries.

Forming a joint venture project team for multi-discipline engineering services in Australia

Joint venture design teams are formed to combine resources and expertise in order to secure multi-discipline engineering design services on major projects. Bringing together resources from two ordinarily competing companies to form one joint team is however challenging as each parent company brings to the project its own organisational culture, processes and team attitudes. This study examined the factors that impact on forming a successful joint venture project team. Three critical areas were identified from an extensive literature review; Joint Venture Arrangements, Parent Companies and Forming the Team; and a survey was conducted with professionals who have worked in joint venture project teams in the Australian building industry in order to identify factors that affected successful joint venture team formation, and the common lessons learnt. This study reinforced the importance of three key criteria - trust, commitment and compatibility - for partner alignment. The results also identified four key lessons learnt which included; selecting the right resources, enabling a collaborative working environment by way of project office, implementing an independent Joint Venture Manager, and allocating work which is best for project with fees reflecting risk where risk is disproportionate.

Rural high school students' attitudes towards school science

This paper reports findings from an Australian survey of Year 10 students (N=3759) indicating that those in small rural and remote areas tend to enjoy school science significantly less than their peers in larger towns and cities (Lyons & Quinn, 2010). The study also found that rural and remote students were less inclined than those in other locations to enjoy science relative to other subjects. Such a result has not previously been recorded in the science education literature and raises a number of questions about the relevance and quality of the science education experienced by rural and remote students. It also raises timely questions about the applicability to rural and remote students of an Australian Science Curriculum. The paper explores these issues and their implications for policy and research.

What further benefit, if any, might Australia get from the ALI-III Transnational Insolvency: Global Principles for Cooperation in International Insolvency Cases?

In 2006, the American Law Institute (ALI) and the International Insolvency Institute (III) established a Transnational Insolvency Project and appointed Professor Ian Fletcher (United Kingdom) and Professor Bob Wessels (Netherlands) as Joint Reporters. The objective was to investigate whether the essential provisions of the ALI Principles of Cooperation among the NAFTA Countries (ALI-NAFTA Principles) and the annexed Guidelines Applicable to Court-to-Court Communication in Cross-border Cases (ALI-NAFTA Guidelines) may, with certain necessary modifications, be acceptable for use by jurisdictions across the world. In 2012, Professor Fletcher and Professor Wessels presented the report Transnational Insolvency: Global Principles for Cooperation in International Insolvency Cases (“ALI-III Report”) to the Annual Meetings of the American Law Institute and the International Insolvency Institute. In 2013, the Australian Academy of Law (AAL) provided support to the authors to undertake research on the possible benefits for Australia of courts and insolvency administrators of referring to the ALI-III Report when addressing international insolvency cases. This AAL project was at the request of the Council of Chief Justices of Australia and New Zealand. This research Report compares the Global Principles for Cooperation in International Insolvency Cases with the Cross-border Insolvency Act 2008 and the UNCITRAL Model Law as it has been adopted and has force of law in Australia. Further, it examines the Global Guidelines for Court-to-Court Communications in International Insolvency Cases in light of Australian cross-border insolvency and procedural law. Finally, it makes brief reference to and commentary on the Global Rules on Conflict–of-Laws Matters in International Insolvency Cases annexed to the ALI-III Report from the perspective of Australian choice of law rules.

Queensland psychiatrists' attitudes and perceptions of adults with intellectual disability

Background: Quality mental health care for adults with an intellectual disability (ID) depends upon the availability of appropriately trained and experienced psychiatrists. There have been few surveys of psychiatrists working with this population. Methods: This Australian study obtained psychiatrists' attitudes to and perceptions of the mental health needs of adults with an ID. Training needs were also sought. The survey instrument used was a purposely designed, 28-item self-administered questionnaire featuring multiple-choice and open-ended questions. Results: The majority of psychiatrists expressed concerns about treatment of this group, describing unmet needs. A total of 75% considered that antipsychotics were overused to control aggression, and 34% of psychiatrists were reluctant to treat adults with an ID. In total, 85% agreed that mental health in ID should be offered as a training option for psychiatric registrars, and that specialized mental health services would provide a high standard of care for this population. Conclusions: Broad concerns are raised regarding pathways to mental health care for adults with an ID in Australia. An Australia-wide training strategy needs to be developed. Partnerships between mental health, disability and community services that serve the mental health needs of this population, should actively seek to engage psychiatrists.

Australian consumer attitudes and decision making on renewable energy technology and its impact on the transformation of the energy sector

This paper critically examines research on consumer attitudes and behavior towards solar photovoltaic (PV) and renewable energy technology in Australia. The uptake of renewable energy technology by residential consumers in Australia in the past decade has transformed the electricity supply and demand paradigm. Thus, this paper reviews Australian research on consumer behavior, understanding and choices in order to identify gaps in knowledge. As the role of the consumer transforms there is a critical need to understand the ways consumers may respond to future energy policies to mitigate unforeseen negative social and economic consequence of programs designed to achieve positive environmental outcomes.

Understanding declining science participation in Australia : a systemic perspective

In this chapter we describe the substantial declines in student participation in senior high school physics, chemistry and biology classes in Australia over the last two decades. We outline some of the explanations commonly offered to account for these declines, focusing on two contrasting positions: first, that they are due to today’s students holding less positive attitudes towards science classes and careers than their predecessors, and second, that the declines are related to policy and structural changes at the upper secondary and tertiary education levels which have affected the relative status of subjects and the dynamics of choice. We describe how the Choosing Science study investigated the extent to which the two hypotheses were supported by empirical evidence, and discuss our findings in the light of a third result from the study concerning the role of self-identity in subject choice. We conclude that the declines in high school science enrolments are most likely related to changes in school and university curriculum options and that within this expanded curriculum marketplace, identity becomes a very important reference point in students’ decisions about whether to take science in the final years of high school.

OHS liability, corporate officers and corporate groups

This article examines the new model for corporate officer liability under section 144 of the Occupational Health and Safety Act 2004 (Vic), and explores the extent to which this might effectively extend responsibility for OHS offences to members of corporate groups, such as holding companies. In doing so, the authors canvass the failure of corporate law to impose such obligations on corporate officers in general, and on holding companies as shadow officers. It is argued that provisions such as section 144 of the Victorian Act should be included in all OHS legislation.

Regulating supply-chains to address the occupational health and safety problems associated with precarious employment: The case of home-based clothing workers in Australia

Over the past 20 years the labour market, workforce and work organisation of most if not all industrialised countries have been significantly refashioned by the increased use of more flexible work arrangements, variously labelled as precarious employment or contingent work. There is now a substantial and growing body of international evidence that many of these arrangements are associated with a significant deterioration in occupational health and safety (OHS), using a range of measures such as injury rates, disease, hazard exposures and work-related stress. Moreover, there is an emerging body of evidence that these arrangements pose particular problems for conventional regulatory regimes. Recognition of these problems has aroused the concern of policy makers - especially in Europe, North America and Australia - and a number of responses have been adopted in terms of modifying legislation, producing new guidance material and codes of practice and revised enforcement practices. This article describes one such in itiative in Australia with regard to home-based clothing workers. The regulatory strategy developed in one Australian jurisdiction (and now being ‘exported’ into others) seeks to counter this process via contractual tracking mechanisms to follow the work, tie in liability and shift overarching legal responsibility to the top of the supply chain. The process also entails the integration of minimum standards relating to wages, hours and working conditions; OHS and access to workers’ compensation. While home-based clothing manufacture represents a very old type of ‘flexible’ work arrangement, it is one that regulators have found especially difficult to address. Further, the elaborate multi-tiered subcont racting and diffuse work locations found in this industry are also characteristic of newer forms of contingent work in other industries (such as some telework) and the regulatory challenges they pose (such as the tendency of elaborate supply chains to attenuate and fracture statutory responsibilities, at least in terms of the attitudes and behaviour of those involved).

Built environment impacts on walking for transport in Brisbane, Australia

This study examines the association between urban form and walking for transport in Brisbane, Australia based on both panel and cross-sectional data. Cross-sectional data are used to determine whether urban form was associated with walking for transport in 2011. Panel data are used to evaluate whether changes in the built environment altered walking behaviour between 2009 and 2011. Results from the cross-sectional data suggest that individuals are significantly more likely to be walkers if they live in an area with a well-connected street network and an accessible train station. The longitudinal analysis confirms these relationships; there also was however, a significant impact of travel attitudes and perceptions on walking behaviour. The findings suggest that the built environment continues to be an important factor to encourage walking; however, interventions are also required to change social norms in order to increase the receptiveness for and participation in walking.