What’s best for our lymphoedema patients? Have we lost the patient as an individual in the quest for good science?

In a recent issue of the Journal of Lymphoedema, Nickolaidis and Karlsson (2013) indicated that most of the standard treatments for lymphoedema patients were explored and developed early last century, and suggested that holistic assessment of the individual is critical for good outcomes, but that perhaps “less emphasis should be placed on manual lymphatic drainage (MLD) and more on compression, exercise and weight reduction.”

Review of Public Trustee Files - Families and generational asset transfers: Making and challenging wills in contemporary Australia

The Public Trustee file review was designed to address research questions relating to will disputes and socio-cultural and family norms, expectations and obligations that underpin challenges to wills. Findings from this review will augment the earlier review of all adjudicated succession law cases in Australia between January and December 2011. The research team obtained 139 cases for the review. Within the reviewed cases, parties generally needed some kind of formalised assistance to resolve disputes and almost a third ended up going to court. Most claims launched to contest wills were successful i.e. led to a change in distribution. The existence of poor and/or complex personal relationships between beneficiaries, disputants and/or the deceased were a feature of most cases involving will disputes, particularly where disputes were escalated to court. There are significant costs of will contestation both for the estate and the individuals involved in disputes. Previous research has identified that in addition to the direct costs is the indirect cost of extending the time for probate of the will. This review highlights that one of the most significant costs of will contestation is the damage to familial relationships that appears to both drive and be worsened by contestation. Findings of this review highlight the role of Public Trustees in providing financial management and advocacy services to protect and support vulnerable people in the community such as those with impaired capacity, as well as offering services such as will drafting and deceased estate administration.

Patient engagement: What and who is it good for?

A huge and diverse literature emphasises that patient engagement is a key factor in: effective health service delivery; quality and safety; responsive health services; patient satisfaction; improved health outcomes; and reduced health care costs. Yet there are also cautionary caveats regarding this discourse. Additionally, although contemporary recommendations regarding good practice and National Health Standards point to the importance of patient engagement and health service providers are striving to implement them in practice, on the ground patient engagement is ‘all things to all people’ with widespread confusion about what patient engagement is and how it could be facilitated. In terms of scholarship, there is a dearth of theoretical and critical examination of what patient engagement constitutes, its application and effects. This analysis aims to contribute to scholarly debate and increased understanding of the use of patient engagement in health policy and practice.

Survivorship care provision for patients with hematologic malignancies: The quest for quality evidence

This is an editorial that depicts the importance for developing more quality evidence to guide the survivorship care provision for patients with hematologic malignancies. Treatments for hematologic malignancies are often complex and debilitating, with increased risk of immune suppression and infections1. Some patients receive allogeneic stem cell transplantation that often requires in-patient stay of several weeks and life-long medical follow up. In recent years, advances in treatment regimens, and an aging population saw an increasing number of patients living with a hematologic malignancies or surviving curative therapy.2 The increased use of targeted therapies in hematologic malignancies (e.g. rituximab for non-Hodgkin lymphoma, bortezomib in multiple myeloma and imatinib in Chronic Myelogenous Leukemia has also resulted in improved overall survival...

Person–organization fit and public service motivation in the context of change

This study examines public sector change, motivation and person–organization (P–O) fit in a stress context. The results provide empirical evidence that change initiatives produce change-induced stressors. However, change processes, including participation in change decision-making and the provision of change information, increase public service motivation, reduce change-induced stressors and ultimately improve P–O fit and job satisfaction. The results also depict that, in the context of change, public service motivation positively influences job satisfaction, with this relationship partially mediated by P–O fit. Implications for New Public Management and the importance of change processes for reducing workplace stress are discussed.

‘Appreciate A Mate’ Helping others to feel good about themselves. Safe and Well Online: A report on the development and evaluation of a positive messaging social marketing campaign for young people.

This report describes the Year Two/Campaign Two processes, and articulates findings from the major project components designed to address the challenges noted above (see Figure 1). Three major components comprise the Safe and Well Online project: 1) A participatory design (PD) process involving young people and sector partners (UWS) for; 2) campaign development (Zuni & Digital Arts Network); and 3) a cohort study (University of South Australia) to evaluate campaign effectiveness and attitude and behaviour change. Each sub-study comprehensively considered the ethical requirements of conducting online research with minors. The theoretical and methodological framework for measuring campaign engagement and efficacy (Sub-studies 3, 4 and 5) drew on the Model of Goal Directed Behaviour (MGB) (Perugini & Bagozzi 2001) and Nudge Theory (Thaler & Sunstein, 2008). This report extends the findings and conclusions of the Year One Pilot Study ‘‘Keep it Tame’’ (Spears et.al, 2015), and details the development and evaluation of the second of four Safe and Well Online Campaigns—‘‘Appreciate A Mate’: Helping others feel good about themselves’.

Inefficient tax slugs all homebuyers

Housing affordability is more than just house prices. It also includes ready access to public transport, schools, good road networks, and of course access to all the basic utilities. However, local governments don’t have the money to build all the infrastructure new housing estates need. So developer charges were introduced as a “user pays” method of funding new urban infrastructure. These charges are levied on property developers by local authorities at the time of planning approval. Some think these costs are passed back to the original land owner by way of lower land prices. But property developers claim these charges are instead added on to new house prices, with a negative impact to housing affordability. When new house prices increase, existing house prices are also dragged up, extending the housing affordability issue throughout the community. However, new research by QUT has uncovered evidence that these costs are not merely passed on to homebuyers, but are passed on at significantly over-inflated rates. In an Australian first, the study empirically examines the impact of developer charges on housing affordability, providing evidence that developer charges are passed on to all homebuyers in the community. So while policy makers think they are charging developers for the provision of infrastructure in new communities, the cost is really being borne by all homebuyers.

A growing good faith in contracts

The Supreme Court of Canada's ruling in Bhasin v Hrynew represents a significant step forward in harmonising the multiple strands of debate surrounding the existence of a good faith provision in common law contracting. Although a general principle of good faith (derived from Roman Law) is recognized by most civil law systems and a growing number of common law countries have embraced statutory provisions towards this end, Bhasin v Hrynew is argued to be a critical advance in catalysing uniform acceptance of good faith as a fundamental principle essential to support an increasingly integrated global commercial environment.

Urban growth and development of contemporary neighbourhood public space in Kathmandu Valley, Nepal

Rapid and unplanned growth of Kathmandu Valley towns over the past decades has resulted in the haphazard development of new neighbourhoods with significant consequences on their public space. This paper examines the development of public space in the valley’s new neighbourhoods in the context of the current urban growth. A case study approach of three new neighbourhoods was developed to examine the provision of public space with data collected from site observations, interviews with neighbourhood residents and other secondary sources. The cases studies consist of both planned and unplanned new neighbourhoods. Findings reveal a severe loss of public space in the unplanned new neighbourhoods. In planned new neighbourhoods, the provision of public space remains poor in terms of physical features, and thus, does not support community activities and needs. Several factors, which are an outcome of the lack of proper urban growth initiatives and control measures, such as an overall drawback in the formation of new neighbourhoods, the poor capacity of local community-based organisations and the encroachment of public land are responsible for the present development of neighbourhood public space. The problems with ongoing management of public spaces are a significant issue in both unplanned and planned new neighbourhoods.

Transparency and ‘uncomfortable knowledge’ in child protection

Australia's child protection systems and the provision of out-of-home care, in particular, have been subject to sustained criticism for decades from dozens of official inquiries and reviews. It is now well established that many children in state care are treated significantly less well than required by relevant legal frameworks and community standards. Much attention and significant resources have been directed toward trying to ameliorate this ‘wicked problem’ and yet it continues. This article focuses on one reason the problems persists, namely the secrecy and closed cultures that characterize relevant organizations which reinforce strategies of denial that avoid acknowledging or dealing with ‘uncomfortable knowledge’. It is a situation many people in child protection systems confront. It is, for example, when we know abuse is taking place, or when they see or are ourselves party to corrupt or negligent practices. It is knowing that important ethical principles are being abrogated. We draw on recent official reports and inquiries noting the repeated calls for greater transparency and independent oversight. An argument is made for a default position of total transparency subject to caveats that protect privacy and any investigation underway. An account of what this can look like is offered.

Public trust in Australian charities: Accounting for cause and effect

This paper reports on a study of the key determinants of public trust in charitable organisations, using survey data commissioned by the Australian Charities and Not-for-profits Commission. Data analysis used partial least squares structural equation modelling to examine both antecedents of trust and the influence of trust on charitable donative intentions. We found that people tend to trust charities with which they are familiar, and which are transparent in their reporting. Organisational size, importance, reputation and national significant were also antecedents of trust. People are more likely to volunteer or donate to charities they trust. The practical implications of this are that charities seeking to enhance their volunteer and donation base should pay attention to their marketing, reputation and disclosure activities, as well as to doing good work on an ongoing basis in the community. Theoretically, the implications are that transparency and reputation do not result directly in donations and volunteering, but they do create trust, and it is trust which then leads to donations and volunteering.

Social media for social good: Value creation in social media based cause brand communities

This thesis presents a case study of value creation in the social media based brand communities of two Australian cause organisations. It improves understanding of how value is created in this increasingly important environment by examining participants' posts and practices, organisational strategies and supporters' perceptions of value creation. The thesis shows that while value creation is complex, value is generated for supporters and organisations alike, and positively influences the outcomes for recipients of the vital services provided by the cause organisations. Value creation in this context thus manifests social good for supporters, service recipients and society at large.

An interactive method for engaging the public health workforce with evidence

Introduction Systematic review authors are increasingly directing their attention to not only ensuring the robust processes and methods of their syntheses, but also to facilitating the use of their reviews by public health decision-makers and practitioners. This latter activity is known by several terms including knowledge translation, for which one definition is a ‘dynamic and iterative process that includes synthesis, exchange and ethically sound application of knowledge’.1 Unfortunately—and despite good intentions—the successful translation of knowledge has at times been inhibited by the failure of reviews to meet the needs of decision-makers, and the limitations of the traditional avenues by which reviews are disseminated.2 Encouraging the utilization of reviews by the public health workforce is a complex challenge. An unsupportive culture within the workforce, a lack of experience in assessing evidence, the use of traditional academic language in communication and the lack of actionable messages can all act as barriers to successful knowledge translation.3 Improving communication through developing strategies that include summaries, podcasts, webinars and translational tools which target key decision-makers such as HealthEvidence.org should be considered by authors as promising actions to support the uptake of reviews into practice.4,5 Earlier work has also suggested that to better meet the research evidence needs of public health professionals, authors should aim to produce syntheses that are actionable, relevant and timely.2 Further, review authors must interact more with those who will, or could use their reviews; particularly when determining the scope and questions to which a review will be directed.2 Unfortunately, individual engagement, ideal for examining complex issues and addressing particular concerns, is often difficult, particularly when attempting to reach large groups where for efficiency purposes, the strategy tends to be didactic, ‘lecturing’ and therefore less likely to change attitudes or encourage higher order thinking.6 …

Qualitative study of patients' choice between public and private hospital emergency departments

Objective The aim of this study was to gather patients' perceptions regarding their choice between public and private hospital EDs for those who hold private health insurance. The findings of this study will contribute to knowledge regarding patients' decision-making processes and therefore may contribute to the development of evidence based public policies. Methods An in-depth semi-structured guide was used to interview participants at public and private hospital EDs. Questions sought to identify the issues that were considered by the participants to decide to attend that hospital ED, previous ED experience, expectations of ED services and perceived benefits and barriers to accessing services. Interviews were audio recorded, transcribed verbatim and analysed using content and thematic approaches. Results Four core themes emerged: prior good experience with the hospital, perceived quality of care, perceived waiting times and perceived costs that may explain patients' choice. Patients' choice between public and private EDs can be explained by the interaction of these core themes. The principal issues appear to be concern for gap payments at private hospital ED and waiting times at public hospital ED. Conclusions Patients who choose to attend public EDs appear to value financial concern over waiting time; those who choose to attend private EDs appear to value waiting time ahead of financial concerns.

Allied health growth: What we do not measure we cannot manage

Background Data describing the Australian allied health workforce is inadequate and so insufficient for workforce planning. National health policy reform requires that health-care models take into account future workforce requirements, the distribution and work contexts of existing practitioners, training needs, workforce roles and scope of practice. Good information on this workforce is essential for managing services as demands increase, accountability of practitioners, measurement of outcomes and benchmarking against other jurisdictions. A comprehensive data set is essential to underpin policy and planning to meet future health workforce needs. Discussion Some data on allied health professions is managed by the Australian Health Practitioner Regulation Agency; however, there is limited information regarding several core allied health professions. A global registration and accreditation scheme recognizing all allied health professions might provide safeguards and credibility for professionals and their clients. Summary Arguments are presented about inconsistencies and voids in the available information about allied health services. Remedying these information deficits is essential to underpin policy and planning for future health workforce needs. We make the case for a comprehensive national data set based on a broad and inclusive sampling process across the allied health population.