Post-Fordism, the welfare state and the personal social services: A comparison of Australia and Britain

The Post-Fordist welfare state thesis locates contemporary social welfare change within a wider analysis of the transformation of capitalist accumulation regimes. Whilst this analysis is useful in directing attention to macro socio-economic change, it has for the most part contained three shortcomings. First, the Post-Fordist thesis has overemphasized the role of historical 'breaks' in the development of social welfare as it purportedly passes from Fordism to Post-Fordism. Second, the thesis has assumed a degree of convergence between welfare states as a result of global economic forces. In doing so, it has underemphasized the mediating impact of existing institutional arrangements within nations. Third, the thesis has assumed, rather than demonstrated, the specific changes which are alleged to be taking place in various fields of social welfare. As a consequence, aspects of continuity in social welfare have been neglected. These three lacunae are addressed through a comparative analysis of developments in the personal social services in Australia and Britain. Services to older people are employed as the specific context of comparison in relation to three dimensions of measuring transformation along a Post-Fordist trajectory: a shift from a unitary economy to a mixed economy of service provision; changes in the model of service delivery and consumption; and strengthening the governance function of the central state. This comparative analysis suggests the need for refinement of the Post-Fordist welfare state thesis concerning the restructuring of social welfare and its impact on the personal social services.

A review of three years experience using email and videoconferencing for the delivery of post-acute burns care to children in Queensland

A virtual outpatient service has been established in Queensland for the delivery of post-acute burns care to children living in rural and remote areas of the state. The integration of telepaediatrics as a routine service has reduced the need for patient travel to the specialist burns unit situated in Brisbane. We have conducted 293 patient consultations over a period of 3 years. A retrospective review of our experience has shown that post-acute burns care can be delivered using videoconferencing, email and the telephone. Telepaediatric bums services have been valuable in two key areas. The first area involves a programme of routine specialist clinics via videoconference. The second area relates to ad-hoc patient consultations for collaborative management during acute presentations and at times of urgent clinical need. The families of patients have expressed a high degree of satisfaction with the service. Telepaediatric services have helped improve access to specialist services for people living in rural and remote communities throughout Queensland. (C) 2003 Elsevier Ltd and ISBI. All rights reserved.

The impact of rehabilitation support services on health-related quality of life for women with breast cancer

As the number of women surviving breast cancer increases, with implications for the health system, research into the physical and psychosocial sequelae of the cancer and its treatment is a priority. This research estimated self-reported health-related quality of life (HRQoL) associated with two rehabilitation interventions for breast cancer survivors, compared to a non-intervention group. Women were selected if they received an early home-based physiotherapy intervention (DAART, n = 36) or a group-based exercise and psychosocial intervention (STRETCH, n = 31). Questionnaires on HRQoL, using the Functional Assessment of Cancer Therapy - Breast Cancer plus Arm Morbidity module, were administered at pre-, post-intervention, 6- and 12-months post-diagnosis. Data on a non-intervention group (n = 208) were available 6- and 12-months post-diagnosis. Comparing pre/post-intervention measures, benefits were evident for functional well-being, including reductions in arm morbidity and upper-body disability for participants completing the DAART service at one-to-two months following diagnosis. In contrast, minimal changes were observed between pre/post-intervention measures for the STRETCH group at approximately 4-months post-diagnosis. Overall, mean HRQoL scores (adjusted for age, chemotherapy, hormone therapy, high blood pressure and occupation type) improved gradually across all groups from 6- to 12-months post-diagnosis, and no prominent differences were found. However, this obscured declining HRQoL scores for 20-40% of women at 12 months post-diagnosis, despite receiving supportive care services. Greater awareness and screening for adjustment problems among breast cancer survivors is required throughout the disease trajectory. Early physiotherapy after surgery has the potential for short-term functional, physical and overall HRQoL benefits.

A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer

The purpose of this research was to estimate the cost-effectiveness of two rehabilitation interventions for breast cancer survivors, each compared to a population-based, non-intervention group (n = 208). The two services included an early home-based physiotherapy intervention (DAART, n = 36) and a group-based exercise and psychosocial intervention (STRETCH, n = 31). A societal perspective was taken and costs were included as those incurred by the health care system, the survivors and community. Health outcomes included: (a) 'rehabilitated cases' based on changes in health-related quality of life between 6 and 12 months post-diagnosis, using the Functional Assessment of Cancer Therapy - Breast Cancer plus Arm Morbidity (FACT-B+4) questionnaire, and (b) quality-adjusted life years (QALYs) using utility scores from the Subjective Health Estimation (SHE) scale. Data were collected using self-reported questionnaires, medical records and program budgets. A Monte-Carlo modelling approach was used to test for uncertainty in cost and outcome estimates. The proportion of rehabilitated cases was similar across the three groups. From a societal perspective compared with the non-intervention group, the DAART intervention appeared to be the most efficient option with an incremental cost of $1344 per QALY gained, whereas the incremental cost per QALY gained from the STRETCH program was $14,478. Both DAART and STRETCH are low-cost, low-technological health promoting programs representing excellent public health investments.

Challenges in implementing evidence-based practice into mental health services

This paper highlights challenges in implementing mental health policy at a service delivery level. It describes an attempt to foster greater application of recovery-orientated principles and practices within mental health services. Notwithstanding a highly supportive policy environment, strong support from service administrators, and an enthusiastic staff response to training, application of the training and support tools was weaker than anticipated. This paper evaluates the dissemination trial against key elements to promote sustained adoption of innovations. Organisational and procedural changes are required before mental health policies are systematically implemented in practice.

The effect of enacted capabilities on adoption of a government electronic procurement system by Malaysian SMEs

Prior studies have shown that innovative information systems (IS) adoption behaviour by small-and medium-sized enterprises (SMEs) is greatly dependent on organizational and environmental characteristics. Government influence (i.e., federal and local government agencies) was found to play an important role in the promotion or enforcement of innovative IS adoption by SMEs, and it is vital for ensuring adoption of nationwide innovative IS, particularly in developing economies. This study introduces the construct of enacted capabilities and examines the enacted capabilities that motivate SMEs to use innovative IS (i.e., a government's electronic procurement systems) to its full potential. A model of how enacted capabilities affect IS adoption behaviour through perceived net benefits and attitude is developed. A survey (and follow-up interviews) of CEOs/owners from Malaysian SMEs was conducted. Results indicate the enacted capabilities possessed by SMEs play a prominent role in determining the adoption of government electronic procurement systems by these enterprises.

Post-acute burns education via videoconference for occupational therapists in Queensland

For over five years, post-acute burns care for children in regional areas of Queensland has been provided by videoconference. Some 300 specialist burns consultations are conducted by videoconference annually. To support regional health professionals, particularly occupational therapists who play an integral role in the local management of these children, we have instigated a series of monthly education sessions via videoconference. The sessions have addressed a broad range of topics related to the long-term management of children following a burn injury. During the first six months, up to 22 regional sites participated in multipoint videoconferences. The average number of participants per videoconference was 39 and the average duration of each session was 67 min. Participant satisfaction was measured with a routine survey completed by each site at the conclusion of the videoconference. The survey response rate was 88% (n = 95) and overall feedback was extremely positive. 96% of respondents agreed that the programme provided them with new information and that the content was relevant (95%) and of appropriate depth (84%). The educational programme has provided valuable support to a group of professionals who are taking on greater responsibility for the clinical management of children requiring post-acute burns care.

Towards an understanding of creativity and innovation within professional services and marketing

Greatly increased competition in the professional services and marketing sectors has reinforced the need for firms to develop an organisational culture that facilitates adaptation to changing conditions and competitive threats. More generally, competitive changes within business environments require new and creative ways of organising and managing firms. In order for marketing practitioners to be ahead of competitors in identifying and meeting customer needs, creative thought is essential. An organisational culture that supports creativity and facilitates the adoption of innovative practices, products and services, improves a firm’s ability to remain competitive within an uncertain environment. This paper presents a conceptual model of an organisational culture supporting creativity and innovation. The model posits relationships between creativity and innovation and organisational performance. The main contribution of the paper is to build a foundation for future research directed primarily towards exploring the relationships in the theoretical model of interest. Implications for marketing practitioners are also considered.

Gender and consumer search of the internet

The role of gender differences in the consumption of goods and services is well established in many areas of consumer behaviour and computer use and yet there has been only limited research into such gender-based differences in the information search behaviour of Internet users. This paper reports the gender-based results of an exploratory study of consumer external information search of the web. The study investigated consumer characteristics, web search behaviour, and the post web search outcomes of purchase decision status and consumer judgements of search usefulness and satisfaction. Gender-based differences are reported in all three areas. Consideration of the results suggests they are issues which could inhibit the adoption of online purchasing by female web users. The implications of these results are discussed and a future research agenda proposed.

Instant messaging: A cross-country comparison of factors affecting adoption

This research-in-progress paper utilizes the Technology Acceptance Model (TAM) to determine whether differences exist in the adoption of Instant Messaging (IM) Technologies in Australia, China, Mexico and the USA. Despite significant differences in the technology needed to implement IM (e.g., software supporting Chinese language characters), few barriers exist to the adoption of IM given the environment is in place. We postulate that language interface technology, infrastructure, and culture affect the adoption of IM technology.