Injury and frequency of use of playground equipment in public schools and parks in Brisbane, Australia

Objective: The purpose of this study was to determine the frequency of use of play equipment in public schools and parks in Brisbane, Australia, and to estimate an annual rate of injury per use of equipment, overall and for particular types of equipment. Methods: Injury data on all children injured from playground equipment and seeking medical attention at the emergency department of either of the two children's hospitals in the City of Brisbane were obtained for the years 1996 and 1997. Children were observed at play on five different pieces of play equipment in a random sample of 16 parks and 16 schools in the City of Brisbane. Children injured in the 16 parks and schools were counted, and rates of injury and use were calculated. Results: The ranked order for equipment use in the 16 schools was climbing equipment (3762 uses), horizontal ladders (2309 uses), and slides (856 uses). Each horizontal ladder was used 2.6 times more often than each piece of climbing equipment. Each horizontal ladder was used 7.8 times more than each piece of climbing equipment in the sample of public parks. Slides were used 4.6 times more than climbing equipment in parks and 1.2 times more in public schools. The annual injury rate for the 16 schools and 16 parks under observation was 0.59/100000 and 0.26/100000 uses of equipment, respectively. Conclusions: This study shows that annual number of injuries per standardized number of uses could be used to determine the relative risk of particular pieces of playground equipment. The low overall rate of injuries/100000 uses of equipment in this study suggests that the benefit of further reduction of injury in this community may be marginal and outweigh the economic costs in addition to reducing challenging play opportunities.

Competitive advantage in public-sector organizations: explaining the public good/sustainable competitive advantage paradox

Resource-based views of the firm and in particular Kay's (Why Firms Succeed. Oxford: Oxford Univ. Press, 1995) model of sustainable competitive advantage have been used to advance an understanding of differences in the competitive advantage of private-sector firms. We extend the analysis to a public-sector firm where its major purpose includes engaging in public good by giving away its knowledge base and services. The case highlights the paradox that many public-sector organizations face in simultaneously pursuing public good and sustainable competitive advantage. While Kay's model is applicable for understanding intergovernmental agency competition, we find it necessary to incorporate resource dependency theory to address the paradox. Implications for theory and practice are provided. (C) 2002 Elsevier Inc. All rights reseved.

Use of derivatives in public sector organisations

The present paper develops and tests a model explaining public sector derivative use in terms of budget discrepancy minimization. The model is different from private sector models. Private sector models do not readily translate into the public sector, which typically faces different objectives. Hypotheses are developed and tested using logistic regression over a sample of Australian Commonwealth public sector organizations. It is found that public sector organization derivative use is positively correlated with liabilities and size consistent with the hypotheses concerning budget discrepancy management.

Fixing the system? The experience of service users of the quasi-market in disability services in Australia

A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer 'choice' around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers' cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.

A paralysis in public health policy: water fluoridation in Queensland (1996-2006)

By focusing on developments between 1996 and 2006, this paper explains the reasons for one of Australia’s public health inconsistencies, the comparatively low adoption of adjusted water fluoridation in Queensland. As such, this work involved literature review and traditional historical method. In Queensland, parliamentary support for water fluoridation is conditional on community approval. Political ambivalence and the constraints of the “Fluoridation of Public Water Supplies Act (1963)” Qld have hindered the advocacy of water fluoridation. The political circumstance surrounding the “Lord Mayor’s Taskforce on Fluoridation Report” (1997) influenced its findings and confirms that Australia’s biggest local authority, the Brisbane City Council, failed to authoritatively analyse water fluoridation. In 2004, a private member’s bill to mandate fluoridation failed in a spectacular fashion. In 2005, an official systems review of Queensland Health recommended public debate about water fluoridation. Our principal conclusion is that without mandatory legislation, widespread implementationof water fluoridation in Queensland is most unlikely.

Risk technology in Australia: The role of the job seeker classification instrument in employment services

Promoted as the key policy response to unemployment, the Job Network constitutes an array of interlocking processes that position unemployed people as `problems' in need of remediation. Unemployment is presented as a primary risk threatening society, and unemployed people are presented as displaying various degrees of riskiness. The Job Seeker Classification Instrument (JSCI) is a `technology' employed by Centrelink to assess `risk' and to determine the type of interaction that unemployed people have with the job Network. In the first instance, we critically examine the development of the JSCI and expose issues that erode its credibility and legitimacy. Second, employing the analytical tools of discourse analysis, we show how the JSCI both assumes and imposes particular subject identities on unemployed people. The purpose of this latter analysis is to illustrate the consequences of the sorts of technologies and interventions used within the job Network.

Routine measurement of outcomes in Australia's public sector mental health services

OBJECTIVE: This paper describes the Australian experience to date with a national 'roll out' of routine outcome measurement in public sector mental health services. METHODS: Consultations were held with 123 stakeholders representing a range of roles. RESULTS: Australia has made an impressive start to nationally implementing routine outcome measurement in mental health services, although it still has a long way to go. All States/Territories have established data collection systems, although some are more streamlined than others. Significant numbers of clinicians and managers have been trained in the use of routine outcome measures, and thought is now being given to ongoing training strategies. Outcome measurement is now occurring 'on the ground'; all States/Territories will be reporting data for 2003-04, and a number have been doing so for several years. Having said this, there is considerable variability regarding data coverage, completeness and compliance. Some States/Territories have gone to considerable lengths to 'embed' outcome measurement in day-to-day practice. To date, reporting of outcome data has largely been limited to reports profiling individual consumers and/or aggregate reports that focus on compliance and data quality issues, although a few States/Territories have begun to turn their attention to producing aggregate reports of consumers by clinician, team or service. CONCLUSION: Routine outcome measurement is possible if it is supported by a co-ordinated, strategic approach and strong leadership, and there is commitment from clinicians and managers. The Australian experience can provide lessons for other countries.