The population approach to falls injury prevention in older people : findings of a two community trial

Background: There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury.---------- Aim: To quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.---------- Methods: Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States.---------- Results: The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.---------- Conclusion: The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those are intensively implemented.

Disrupting the new orthodoxy : emergency intervention and Indigenous social policy

This article develops a critical analysis of the ideological framework that informed the Australian Federal government’s 2007 intervention into Northern Territory Indigenous communities (ostensibly to address the problem of child sexual abuse). Continued by recently elected Prime Minister, Kevin Rudd, the NT ‘emergency response’ has aroused considerable public debate and scholarly inquiry. In addressing what amounts to a broad bi-partisan approach to Indigenous issues we highlight the way in which Indigenous communities are problematised and therefore subject to interventionist regimes that override differentiated Indigenous voices and intensify an internalised sense of rage occasioned by disempowering interventionist projects. We further argue that in rushing through the emergency legislation and suspending parts of the Racial Discrimination Act, the Howard and Rudd governments have in various ways perpetuated racialised and neo-colonial forms of intervention that override the rights of Indigenous people. Such policy approaches require critical understanding on the part of professions involved most directly in community practice, particularly when it comes to mounting effective opposition campaigns. The article offers a contribution to this end.

One-time-password-authenticated key exchange

To reduce the damage of phishing and spyware attacks, banks, governments, and other security-sensitive industries are deploying one-time password systems, where users have many passwords and use each password only once. If a single password is compromised, it can be only be used to impersonate the user once, limiting the damage caused. However, existing practical approaches to one-time passwords have been susceptible to sophisticated phishing attacks. ---------- We give a formal security treatment of this important practical problem. We consider the use of one-time passwords in the context of password-authenticated key exchange (PAKE), which allows for mutual authentication, session key agreement, and resistance to phishing attacks. We describe a security model for the use of one-time passwords, explicitly considering the compromise of past (and future) one-time passwords, and show a general technique for building a secure one-time-PAKE protocol from any secure PAKE protocol. Our techniques also allow for the secure use of pseudorandomly generated and time-dependent passwords.

Planning and evaluation

Introduction: The core business of public health is to protect and promote health in the population. Public health planning is the means to maximise these aspirations. Health professionals develop plans to address contemporary health priorities as the evidence about changing patterns of mortality and morbidity is presented. Officials are also alert to international trends in patterns of disease that have the potential to affect the health of Australians. Integrated planning and preparation is currently underway involving all emergency health services, hospitals and population health units to ensure Australia's quick and efficient response to any major infectious disease outbreak, such as avian influenza (bird flu). Public health planning for the preparations for the Sydney Olympics and Paralympic Games in 2000 took almost three years. ‘Its major components included increased surveillance of communicable disease; presentations to sentinel emergency departments; medical encounters at Olympic venues; cruise ship surveillance; environmental and food safety inspections; bioterrorism surveillance and global epidemic intelligence’ (Jorm et al 2003, 102). In other words, the public health plan was developed to ensure food safety, hospital capacity, safe crowd control, protection against infectious diseases, and an integrated emergency and disaster plan. We have national and state plans for vaccinating children against infectious diseases in childhood; plans to promote dental health for children in schools; and screening programs for cervical, breast and prostate cancer. An effective public health response to a change in the distribution of morbidity and mortality requires planning. All levels of government plan for the public’s health. Local governments (councils) ensure healthy local environments to protect the public’s health. They plan parks for recreation, construct traffic-calming devices near schools to prevent childhood accidents, build shade structures and walking paths, and even embed drafts/chess squares in tables for people to sit and play. Environmental Health officers ensure food safety in restaurants and measure water quality. These public health measures attempt to promote the quality of life of residents. Australian and state governments produce plans that protect and promote health through various policy and program initiatives and innovations. To be effective, program plans need to be evaluated. However, building an integrated evaluation plan into a program plan is often forgotten, as planning and evaluation are seen as two distinct entities. Consequently, it is virtually impossible to measure, with any confidence, the extent to which a program has achieved its goals and objectives. This chapter introduces you to the concepts of public health program planning and evaluation. Case studies and reflection questions are presented to illustrate key points. As various authors use different terminology to describe the same concepts/actions of planning and evaluation, the glossary at the back of this book will help you to clarify the terms used in this chapter.

Service driven asset management

Local governments are service driven rather than asset driven. Understanding this distinction is critical to ensuring that community needs are appropriately addressed. Translating community needs and desires into infrastructure is a complex yet little understood process. In this paper, we look at two case studies that explore the interface between service outcomes and the specification of performance requirements for the assets. The two case studies we look at are: a public health issue resulting from inadequate public amenities in a beach resort and the prioritisation of maintenance work in a world of increasing service demands and declining funding. The case studies all use the same investment logic mapping framework to establish clear drivers as to the problem that councils are responding to in delivering their services. The key to the framework is the separation of concern between service management and asset management.

What’em with the apology? : the National Apology to the Stolen Generations two years on

Prime Minister Kevin Rudd’s Apology to Australia’s Stolen Generations, delivered on 13 February 2008, is both personal and political to me just as the people who talk about it make it political and personal through their actions. This paper represents my attempt to turn the gaze through articulating some of my thoughts on the Apology, policy statements (Close the Gap) and the inconsistencies within the leadership of the present governments. I have endeavoured to do this through exploring the articulations of others and by sharing examples and personal experiences. In bringing forth some analysis to the literature, examples and experiences, I reveal the relationships between oppression, white race privilege and institutional privilege and the epistemology that maintains them. In moving from the position of being silent on the Apology, and my political experiences, to speaking about them, I am able to move from the position of object to subject and to gain a form of liberated voice (hooks 1989:9). Furthermore, I am hopeful that it will encourage others to examine their own practices within political parties and governments and to challenge the domination that continues to subjugate Indigenous peoples. It is only through people enacting their responsibilities and making changes in their daily lives and through the institutions and organisations to which they belong (the personal and political), can the Apology move beyond symbolic to action.

Framework and processes for enhancing sustainability deliverables in Australian road infrastructure projects

Road and highway infrastructure provides the backbone for a nation’s economic growth. The versatile dispersion of population in Australia and its resource boom, coupled with improved living standards and growing societal expectations, calls for continuing development and improvement of road infrastructure under the current local, state and federal governments’ policies and strategic plans. As road infrastructure projects involve huge resources and mechanisms, achieving sustainability not only on economic scales but also through environmental and social responsibility becomes a crucial issue. While sustainability is a logical link to infrastructure development, literature study and consultation with the industry found that there is a lack of common understanding on what constitutes sustainability in the infrastructure context. Its priorities are often interpreted differently among multiple stakeholders. For road infrastructure projects which typically span over long periods of time, achieving tangible sustainability outcomes during the lifecycle of development remains a formidable task. Sustainable development initiatives often remain ideological as in macro-level policies and broad-based concepts. There were little elaboration and exemplar cases on how these policies and concepts can be translated into practical decision-making during project implementation. In contrast, there seemed to be over commitment on research and development of sustainability assessment methods and tools. Between the two positions, there is a perception-reality gap and mismatch, specifically on how to enhance sustainability deliverables during infrastructure project delivery. Review on past research in this industry sector also found that little has been done to promote sustainable road infrastructure development; this has wide and varied potential impacts. This research identified the common perceptions and expectations by different stakeholders towards achieving sustainability in road and highway infrastructure projects. Face to face interviews on selected representatives of these stakeholders were carried out in order to select and categorize, confirm and prioritize a list of sustainability performance targets identified through literature and past research. A Delphi study was conducted with the assistance of a panel of senior industry professionals and academic experts, which further considered the interrelationship and influence of the sustainability indicators, and identified critical sustainability indicators under ten critical sustainability criteria (e.g. Environmental, Health & Safety, Resource Utilization & Management, Social & Cultural, Economic, Public Governance & Community Engagement, Relations Management, Engineering, Institutional and Project Management). This presented critical sustainability issues that needed to be addressed at the project level. Accordingly, exemplar highway development projects were used as case studies to elicit solutions for the critical issues. Through the identification and integration of different perceptions and priority needs of the stakeholders, as well as key sustainability indicators and solutions for critical issues, a set of decision-making guidelines was developed to promote and drive consistent sustainability deliverables in road infrastructure projects.

Land Use & Public Transport Accessibility Index (LUPTAI) tool : the development and pilot application of LUPTAI for the Gold Coast

LUPTAI is a decision-aiding tool to enable local and state governments to optimise land use and transport integration. In contrast to mobility between land uses (typically via road), accessibility represents opportunity and choice to reach common land use destinations by public transport and/or walking. LUPTAI uses a GIS-based methodology to quantify and map accessibility to common land use destinations by walking and/or public transport. The tool can be applied to small or large study areas. It can be applied to the current situation in a study area or to future scenarios (such as scenarios involving changes to public transport services, public transport corridors or stations, population density or land use). The tool has been piloted on the Gold Coast and the results are encouraging. This paper outlines the GIS-based methodology and the findings related to this pilot study. The paper demonstrates benefits and possible application of LUPTAI to other urbanised local government areas in Queensland. It also discusses how this accessibility indexing approach could be developed into a decision-support tool to assist local and state government agencies in a range of transport and land-use planning activities.

Holding and opportunity cost theory in a property development context

This paper focuses on the varying approaches and methodologies adopted when the calculation of holding costs is undertaken, focusing on greenfield development. Whilst acknowledging there may be some consistency in embracing first principles relating to holding cost theory, a review of the literature reveals considerable lack of uniformity in this regard. There is even less clarity in quantitative determination, especially in Australia where there has been only limited empirical analysis undertaken. Despite a growing quantum of research undertaken in relation to various elements connected with housing affordability, the matter of holding costs has not been well addressed regardless of its part in the highly prioritised Australian Government’s housing research agenda. The end result has been a modicum of qualitative commentary relating to holding costs. There have been few attempts at finer-tuned analysis that exposes a quantified level of holding cost calculated with underlying rigour. Holding costs can take many forms, but they inevitably involve the computation of “carrying costs” of an initial outlay that has yet to fully realise its ultimate yield. Although sometimes considered a “hidden” cost, it is submitted that holding costs prospectively represent a major determinate of value. If this is the case, then considered in the context of housing affordability, it is therefore potentially pervasive.

Community engagement : exploring a relational approach to consultation and collaborative practice in Australia

Community engagement is increasingly being employed by Australian organizations as a key strategy to incorporate representative community opinions into decision-making. This trend is reflected by Australian local and state governments legislating for community consultation in major infrastructure projects and the increasing role of public relations practitioners to manage these programs. This study explores community engagement founded on relational theory and proposed a typology of engagement employing a relational framework. An exploratory study of 20 Australian infrastructure projects with a mandatory consultation component is analyzed applying this framework. Results indicate little discrimination between the terms engagement, consultation, and participation; however, a range of tactics supported both collaborative and advocacy approaches. The implications for adopting a relational framework for community engagement programs are discussed.

ACE's role in developing Australia's human capital : a structural analysis

This project explored ways in which Adult and Community Education (ACE) could make a greater contribution to the human capital development outcome under the National Reform Agenda (NRA), and increase the number of skilled workers in Australia. Data on current vocational and non-vocational ACE programs was analysed. Strategies to improve ACE were collated for consideration by government authorities and ACE providers. There is much diversity in the perceived role and activities of ACE. Researchers have found it challenging to create a profile that depicts the whole sector, particularly in the absence of much reliable, valid and comparable data on ACE activities and outcomes. However, there is evidence indicative of ACE’s assistance in re-engaging with learning and training, and initiating pathways to further training or employment. The potential for ACE to make a bigger contribution to skilling Australia is recognised by governments across the nation (Senate Employment, Workplace Relations, Small Business and Education Committee, 1997). Yet policy changes to facilitate an increased role of ACE in the skilling process, and resourcing for ACE programs continue to receive less attention. This project explored three research questions: • What does the current profile of the ACE sector look like? • How is ACE contributing to reducing the skills deficit? • How can ACE enhance its contributions to reduce the skills deficit and achieve the human capital development outcome of the National Reform Agenda? The responsiveness

Social capital in a tolerant society? a response to treasurer Costello’s presentation to the Sydney Institute

On 16 July 2003 the Australian Government’s Treasurer, the Honourable Peter Costello, addressed the Sydney Institute on his vision for a tolerant Australian society. Drawing from Putnam’s research Costello argued that tolerance will flow from an active voluntary sector. However, Costello’s proposed model for a “tolerant” society fails to acknowledge that all behaviour is strategic and that voluntary association based on disinterested action is not possible. Ultimately, Treasurer Costello’s notion of tolerant society fuelled by an active voluntary sector may not lead to his desired end. Indeed, the promotion of voluntary association may contribute to the ongoing exclusion of citizens with low social capital. Amid the dynamism of the modern era some citizens such as ageing workers, slow or ineffective learners and women may be especially at risk. Accordingly, rather than advocating a policy approach that seeks to build inclusiveness through an active voluntary sector this paper recommends a policy approach that explores ways in which to strengthen learning and the wider involvement of individuals through both formal and informal means.

Enablers and barriers to the organizational adoption of sustainable business practices

Individuals, organizations, and governments are increasingly becoming aware of the necessity of sustainability in living, organizing, performing, and managing work. In this context, “green IS” has become an established colloquial term, acknowledging that information technology, corporate information systems, and the surrounding practices are both a contributor to the sustainability challenge and a potential enabler for green and sustainable practices. To date, however, there are few reported studies on the role of information systems for the challenge, and solution, of sustainability. This paper presents results from a case study of a world-wide operating IT software solution provider that is engaged in the development and adoption of sustainable practices. Our study suggests that the adoption of sustainable practices comes along with a number of particularities. We found information technology to be a key enabler of transparency about the progress of sustainability operations. We further found personal, motivator factors as well as organizational factors such as business inclusion, strategy definition, and a dialectic top-management and bottom-up support, to play a role in enabling a company to manage their sustainability. We describe a set of conjectures forthcoming from our case analysis, and detail some implications for further research in this area.

Behavioural biases and information disclosure laws relating to residential property sales : narrowing the gap between existing laws and calls for future reforms

Market failures involving the sale of complex merchandise, such as residential property, financial products and credit, have principally been attributed to information asymmetries. Existing legislative and regulatory responses were developed having regard to consumer protection policies based on traditional economic theories that focus on the notion of the ‘rational consumer’. Governmental responses therefore seek to impose disclosure obligations on sellers of complex goods or products to ensure that consumers have sufficient information upon which to make a decision. Emergent research, based on behavioural economics, challenges traditional ideas and instead focuses on the actual behaviour of consumers. This approach suggests that consumers as a whole do not necessarily benefit from mandatory disclosure because some, if not most, consumers do not pay attention to the disclosed information before they make a decision to purchase. The need for consumer policies to take consumer characteristics and behaviour into account is being increasingly recognised by governments, and most recently in the policy framework suggested by the Australian Productivity Commission

Physical and environmental determinants

This chapter describes physical and environmental determinants of the health of Australians, providing a background to the development of successful public health activity. Health determinants are the biomedical, genetic, behavioural, socio-economic and environmental factors that impact on health and wellbeing. These determinants can be influenced by interventions and by resources and systems (AIHW 2006). Many factors combine to affect the health of individuals and communities. People’s circumstances and the environment determine whether the population is healthy or not. Factors such as where people live, the state of their environment, genetics, their education level and income, and their relationships with friends and family, all are likely to impact on their health. The determinants of population health reflect the context of people’s lives; however, people are very unlikely to be able to control many of these determinants (WHO 2007). This chapter and Chapter 6 illustrate how various determinants can relate to, and influence other determinants, as well as health and wellbeing. We believe it is particularly important to provide an understanding of determinants and their relationship to health and illness in order to provide a structure in which a broader conceptualisation of health can be placed. Determinants of health do not exist in isolation from one another. More frequently they work together in a complex system. What is clear to anyone who works in public health is that many factors impact on the health and wellbeing of people. For example, in the next chapter we discuss factors such as living and working conditions, social support, ethnicity and class, income, housing, work stress and the impact of education on the length and quality of people’s lives. In 1974, the influential ‘Lalonde Report’ (Lalonde 1974) described key factors that impact on health status. These factors included lifestyle, environment, human biology and health services. Taking a population health approach builds on the Lalonde Report, and recognises that a range of factors, such as living and working conditions and the distribution of wealth in society, interact to determine the health status of a population. Tackling health determinants has great potential to reduce the burden of disease and promote the health of the general population. In summary, we understand very clearly now that health is determined by the complex interactions between individual characteristics, social and economic factors and physical environments; the entire range of factors that impact on health must be addressed if we are to make significant gains in population health, and focussing interventions on the health of the population or significant sub-populations can achieve important health gains. In 2007, the Australian Government included in the list of National Health Priority Areas the following health issues: cancer control, injury prevention and control, cardiovascular health, diabetes mellitus, mental health, asthma, and arthritis and musculoskeletal conditions. The National Health Priority Areas set the agenda for the Commonwealth, States and Territories, Local Governments and not-for-profit organisations to place attention on those areas considered to be the major foci for action. Many of these health issues are discussed in this chapter and the following chapter.