The equipping inclusion studies : assistive technology use and outcomes in Victoria ; key findings and policy implications, study 1 - the equipment study, study 2 - the economic study

Approximately one in five of the Australian population lives with disability (AIHW 2006a; ABS 2003). Of these, almost 1.9 million rely on assistive technologies to live independently (Hobbs, Close, Downing, Reynolds & Walker 2009).

Assistive Technology (AT) is defined as,

‘any device, system or design, whether acquired commercially or off the shelf, modified or customised, that allows an individual to perform a task that they would otherwise be unable to do, or increase the ease and safety with which a task can be performed’ (Independent Living Centres Australia n.d).

‘Assistive Technology solutions’ have been defined as entailing a combination of devices (aids and equipment), environmental modifications (both in the home and outside of it), and personal care (paid and unpaid) (Assistive Technology Collaboration n.d).

Despite a large number of Australians relying on AT, there is little data available about life for these Australians, the extent of AT use, or unmet need for AT. Existing research in Australia suggests that aids and equipment provision in Australia is ‘fragmented’ across a plethora of government and non government programs (AIHW 2006a:35). In Victoria, one of the prime sources of government funding for AT is the Victorian Aids and Equipment Program (VAEP) which is a subsidy program for the purchase of aids and equipment, home and vehicle modifications for people with permanent or long term disability. Recent research suggests that waiting times for accessing equipment through the VAEP are high, as is the cost burden to applicants (Wilson, Wong & Goodridge 2006). In addition, there appears to be a substantial level of unmet need (KPMG 2007).

Additionally, there is a paucity of literature around the economic evaluation of AT interventions and solution packages, resulting in little evidence of their cost-effectiveness credentials.

Type 2 diabetes prevalence varies by socio-economic status within and between migrant groups: analysis and implications for Australia

Background:
Ethnic diversity is increasing through migration in many developed countries. Evidence indicates that type 2 diabetes mellitus (T2DM) prevalence varies by ethnicity and socio- economic status (SES), and that in many settings, migrants experience a disproportionate burden of disease compared with locally-born groups. Given Australia’s multicultural demography, we sought to identify groups at high risk of T2DM in Victoria, Australia.

Towards a market oriented approach: employer requirements and implications for undergraduate economics programs

The decline in enrolments in economics degrees and majors has been the focus of much concern in recent times. In 2001, two of the current researchers published a paper outlining a framework with which future investigation into this issue could be conducted. Essentially this paper argued that a market oriented approach, which takes into account the value students and employers place on economics studies may point the way to a solution to the problem. As a first step in developing such an approach it is necessary to determine what employers require of the economics graduates they hire. A survey was conducted in 2002. This paper presents the results of this survey and discusses some of the ramifications for the teaching of undergraduate economics.

Trends in children`s physical activity and weight status in high and low socio-economic status areas of Melbourne, Victoria, 1985-2001

Objective:
To examine trends in active transport to and from school, in school sport and physical education (PE), and in weight status among children from high and low socio-economic status (SES) areas in Melbourne, Victoria, between 1985 and 2001.

Methods:
Cross-sectional survey data and measured height and weight from 1985 (n=557) and 2001 (n=926) were compared for children aged between 9–13 years within high and low SES areas.

Results:
From 1985 to 2001, the frequency of walking to or from school declined (4.38±4.3 vs. 3.61 ± 3.8 trips/wk, p<0.001), cycling to or from school also declined (1.22±2.9 vs. 0.36±1.5 trips/wk, p<0.001), and the frequency of PE lessons declined (1.64±1.1 vs. 1.18±0.9 lessons/wk, p<0.001). However, the frequency of school sport increased (0.9±1.22 vs. 1.24±0.8 sessions/wk, p<0.001). In 1985, 11.7% of children were overweight or obese compared with 28.7% in 2001 (p<0.001). Apart from walking to school and school sport, there were greater relative declines in cycling to school and PE, and increases in overweight and obesity among children attending schools in low SES areas compared with those attending schools in high SES areas.

Conclusions:
Declines in active school transport and PE have occurred at the same time as increases in overweight and obesity among Australian children.

Implications:
Promoting active school transport and maintaining school sport and PE should be important public health priorities in Australia. Current inequities in school sport and PE and in prevalence of overweight and obesity by area-level SES also need to be addressed.

Local perceptions of sustainability indicators: issues of scale and implications for management

A key factor impacting upon sustainable development are the perceptions people hold of their local social, economic and ecological environment. These perceptions influence how communities fashion the local landscape and in turn help to condition the ways people adapt themselves to their local spatial realities. Implicit in these perceptions are indicators of sustainability that may or may not be integrated across the social, economic and ecological realms. Further, these local indicators may not accord with those adopted at the national or global scale. Accordingly, spatial scale presents a particular set of challenges in identifying appropriate indicators of sustainability. In the same way that aggregated changes at a local scale influence sustainability on a broad scale, national and global externalities profoundly affect perceptions relating to sustainable development at the finest of spatial scales.

This paper focuses on one aspect of the issue of scale in sustainable indicator selection: local perceptions of sustainability. In this paper we report on a survey of perceptions of sustainability conducted across thirty-two sub-catchments in three major catchments in south west Victoria. We sought to uncover what people within each sub-catchment perceived as socially, economically and ecologically sustainable. Responses were compared across sub-catchments to determine whether perceptions at the sub-catchment scale were shared across the region. The results indicate that perceptions of sustainability varied between sub-catchments, which means that perceptions relating to sustainability at the regional scale may mask local trends.

Diminishing and negative welfare returns of economic growth : an index of sustainable economic welfare (ISEW) for Thailand

Thailand has achieved remarkable levels of economic growth over the last three decades. This sustained economic growth has played a major role in reducing absolute poverty levels from nearly one third of the population in 1975 to presently less than 10%, thus increasing the welfare of many Thais. This performance ranks Thailand as one of the world's most successful economies during this period. However, an increasing number of studies have begun to find that at a certain point achieving economic growth stops improving welfare and actually begins to diminish it due to the hidden and traditionally unreported costs of associated with this growth. With one exception, these new studies have focussed on high-income countries. This study will estimate an index of sustainable economic welfare (ISEW) for a developing country, Thailand, over a 25-year period, 1975–1999. This paper concludes that even low–middle income countries are beginning to approach the point in which economic growth produces both diminishing and, at times, negative welfare returns as the costs of achieving economic growth begin to outweigh the benefits. These results are important for policy makers and highlight the importance of implementing alternative welfare enhancing interventions that must be considered in place of simply achieving economic growth. The emphasis of this paper is not on the methodology of estimating the ISEW for Thailand, but rather on the policy implications for developing countries of diminishing and negative welfare returns brought about through the achievement of economic growth.

Economic growth and sustainability - an empirical study of the Thai development experience

Increasing economic growth has long been the dominant position within the public policies of all South East Asian countries. More recently, a new issue, sustainability, has emerged within development economic literature, which has significant implications for the continual pursuit of economic growth. Sustainability is concerned with ensuring the current generation meets their present needs without threatening future generations' ability to do likewise. This ability is dependent on a healthy and functioning socio-economic environmental (SEE) system. Economic growth can damage the SEE-system, though, through resource degradation, over-harvesting and pollution. Therefore, achieving economic growth and sustainability simultaneously may not be possible. This paper discusses these tensions between economic growth and sustainability by undertaking a number of SEE-based adjustments to GDP in order to measure sustainability. Thailand is used as a case study for a 25 year period, 1975-1999. The adjustments include the environmental costs caused by economic growth such as noise pollution, water pollution, the depletion of non-renewable resources, and deforestation. The results show a stark difference in terms of GDP per capita and the SEE-adjusted GDP per capita figure. The paper concludes that with increasing environmental costs of economic growth, pursuing high growth objectives without considerations to the environment threatens sustainability

Employer requirements of economics graduates and the implications for undergraduate economics programs

In recent years there has been considerable debate about the general decline in the number of students undertaking bachelor degrees and majors in economics. The discussion has stemmed mainly from a supply-side perspective of the economics education market. The goal of this paper is to add another dimension to the debate and report the results of a survey of employers of economics graduates. Drawing on the extensive customer services literature it is argued that a market oriented, or demand-side analysis is also an important component in redressing low student enrolments and retention. A first step in adopting a market oriented approach is to determine the skills required of the economics graduates entering the jobs market. With the support of The Economics Society of Au~tralia, twenty-nine public and private sector employers were surveyed in 2002. The aim of the survey was to establish the demand for economics graduates with bachelor and honours degrees, the skills and knowledge required of these graduates, and the performance of such graduates. The study found that economic knowledge and skill were important to employers. However, the skills rated most important by employers were the more general or 'generic' skills of clear writing, data analysis, interpersonal skills and a practical problem-solving orientation. While graduates generally performed satisfactorily in relation to the economic skills required by employers, this was not the case for generic skills. The result of the survey findings have some significant implications for the content and teaching of undergraduate economics programs. This paper outlines these implications and also discusses areas for future research It is argued that such research should aim to utilize both the demand and supplyside perspectives with the development of more precise definitions and measurement of the economic skills required by the various stakeholders in the economics education market.

Comparing Australias genuine progress to its economic growth performance

Australia has recorded consistently strong levels of economic growth in recent times. Under conventional considerations, the well-being experienced by Australians would also be considered to have increased in equal terms over this period. This is because aggregate standard national accounts have from their inception been assigned as proxy measures of well-being both within the economic literature and public debate. However, this approach fails to consider a number of important economic costs and non-welfaristic impacts on well-being associated with a growing economy. As a result, figures such as Gross Domestic Product (GDP) per capita over-estimate well-being. It is possible to adjust these estimates to overcome these limitations. Within this paper, the sustainable well-being of Australia will be reviewed by estimating a Genuine Progress Indicator (GPI) for the period 1986–2003. Policy implications following from this new analysis will also be discussed.

Stem cell research and ethics : a socio-economic and marketing perspective

This paper addresses the ethical and moral issues surrounding stem cell research (SCR) and development within the socio-economic and macro marketing environments. A two dimensional conceptual framework is developed towards broadening the understanding of the complexities of these issues in an international context. The conceptual model captures the two dimensions of narrow moral/ethical to broader imperatives and the cost-benefits realm of SCR. Four quadrants emerge within these two dimensions which are likely to help identify the dominant views and the people associating themselves with these views in terms of their demographics and psychographic characteristics. These findings have important socio-economic and marketing implications which are highlighted in the paper.

Economic Evaluation of a Primary Care Trial to Reduce Weight Gain in Overweight/Obese Children: The LEAP Trial

Background:- A common policy response to the childhood obesity epidemic is to recommend that primary care physicians screen for and offer counseling to the overweight/obese. As the literature suggests, this approach may be ineffective; it is important to document the opportunity costs incurred by brief primary care obesity interventions that ultimately may not alter body mass index (BMI) trajectory.

Methods:- Live, Eat and Play (LEAP) was a randomized controlled trial of a brief secondary prevention intervention delivered by family physicians in 2002-2003 that targeted overweight/ mildly obese children aged 5 to 9 years. Primary care utilization was prospectively audited via medical records, and parents reported family resource use by written questionnaire. Outcome measures were BMI (primary) and parent-reported physical activity and dietary habits (secondary) in intervention compared with control children.

Results:- The cost of LEAP per intervention family was AU $4094 greater than for control families, mainly due to increased family resources devoted to child physical activity. Total health sector costs were AU $873 per intervention family and AU $64 per control, a difference of AU $809 {P < .001). At 15 months, intervention children did not differ significantly in adjusted BMI or daily physical activity scores compared with the control group, but dietary habits had improved.

Conclusions:- This brief intervention resulted in higher costs to families and the health care sector, which could have been devoted to other uses that do create benefits to health and/or family well-being. This has implications for countries such as the United States, the United Kingdom, and Australia, whose current guidelines recommend routine surveillance and counseling for high child BMI in the primary care sector.

Quality of life of Australian family carers : implications for research, policy and practice

Abstract As part of an international,multicentered project, the burden of care, health, and subjective well-being experienced by select Australian family carers supporting a relative with disability at home were investigated. Some 448 family carers residing in New South Wales and Tasmania completed a battery of instruments, including a self-report demographic survey, the Family Caregiver Burden Inventory, the General Health Questionnaire, and the Personal Wellbeing Index. Respondents were predominantly females (mean
age = 48 years), married, and supporting a son or daughter with an intellectual disability (mean age = 18 years). Although caring for their family member was not perceived to be a burden, respondents reported notable limitations on their social networks and social activities. They reported higher levels of unemployment than would be expected for the general population and were over represented in lower income groups. They reported seriously low levels of mental health and personal well-being when compared with the general population. The findings revealed that this group of family carers were at high risk of social and economic disadvantage and at high risk of mental health challenges. Social policy makers and service providers should take these factors into account, both in the interests of promoting the health and well-being of the carers and considering the long-term needs of family members with disability who rely on family carers for daily support when designing services.