Just out of reach : access to equity in Australian higher education

This paper provides an account of access and equity in Australian higher education across the period of recent Federal Labor governments and specifically of the discourses and practices surrounding A Fair Chance For All: Higher Education That's Within Everyone's Reach, Labor's latest policy on equal access to Australian higher education. The paper positions such an account within Australia's changing national and global economic condition, and the influence of New Right ideologies that proffer efficient and effective public sector management practices and market freedoms that have witnessed a privatisation and peeling back of the welfare state. The paper argues that while Federal Labor has clearly established social justice on the agenda of Australian higher education, it is a justice mediated by particular economic and managerial practices which tend to limit equity to issues of access and place broader equity concerns for higher education just out of reach.

Reduced food access due to a lack of money, inability to lift and lack of access to a car for food shopping : a multilevel study in Melbourne, Victoria

Objective: To describe associations between demographic and individual and arealevel socio-economic variables and restricted household food access due to lack of money, inability to lift groceries and lack of access to a car to do food shopping.
Design: Multilevel study of three measures of restricted food access, i.e. running out of money to buy food, inability to lift groceries and lack of access to a car for food shopping. Multilevel logistic regression was conducted to examine the risk of each of these outcomes according to demographic and socio-economic variables.
Setting: Random selection of households from fifty small areas in Melbourne, Australia, in 2003.
Subjects: The main food shoppers in each household (n 2564).
Results: A lack of money was significantly more likely among the young and in households with single adults. Difficultly lifting was more likely among the elderly and those born overseas. The youngest and highest age groups both reported reduced car access, as did those born overseas and single-adult households. All three factors were most likely among those with a lower individual or household socio-economic position. Increased levels of area disadvantage were independently associated with difficultly lifting and reduced car access.
Conclusions: In Melbourne, households with lower individual socio-economic position and area disadvantage have restricted access to food because of a lack of money and/or having physical limitations due difficulty lifting or lack of access to a car for food shopping. Further research is required to explore the relationship between physical restrictions and food access.

Mobile technology platforms for flexible access to information resources : considerations in the use of ebook readers, smart phones, netbooks and iPads

Smart phones are everywhere, people are taking eBook readers on holiday, the iPad has queues of people wanting to buy one, and some netbooks can fit in a pocket. The technology is attractive and increasingly affordable – how can it help an individual in their access to and use of texts, journals, databases, clinical sources, the web and day-to-day information? The Library has been investigating and trialling mobile devices during 2010, and has received interesting feedback from staff and students on the effectiveness of the technology in the University and personal environments. Each device has its strengths and weaknesses depending on the needs of the individual or activity it is supporting – productivity, research, study, clinical or recreational. The presentation will explore these issues along with some of the practical implications at Deakin, and international experiences in academic environments.

Better access to mental health program : influence of mental health occupational therapy

Background/aim

The Better Access to Mental Health program has enabled eligible occupational therapists to provide services to people with a mental health condition. No studies have yet reported the influence of occupational therapy under this scheme. The aim of this study was to investigate whether attending an occupational therapist under this initiative influences change in psychological distress of clients as measured by the Kessler Psychological Distress Scale (K10).
Method

A quasi-experimental pretest–posttest design, using pre-existing data collected in the process of regular treatment was used. Data from a total of 31 clients (mean = 17.13 years, SD = 3.603) were accessed for this study. Pre- and post-intervention scores on the K10 were used to determine if psychological distress had changed over the course of intervention.
Results

Highly significant improvements (P < 0.001) were found between the K10 pre-intervention score (mean = 25.68, SD = 9.944) and the K10 post-intervention score (mean = 21.00, SD = 9.212). Male K10 post-intervention scores (mean = 17.64, SD = 5.3) significantly improved (P = 0.05), whereas results for females were not statistically significant. Medication use, diagnosis, age, number of sessions and prior contact with health services did not influence the results. Results from specific evidence-based interventions were not able to be considered in this study.
Conclusion

The results of this study demonstrate effectiveness of occupational therapy services for adolescents and provide support for the ongoing participation of occupational therapists in this scheme.

The politics of the pharmaceutical industry and access to medicines : world pharmacy and India

The Pharmaceutical Industry presents one of India’s most successful stories of economic expansion and improvements in public health. Indian firms have made access to quality medicines possible and affordable in many developing countries. Indian pharmaceuticals are also exported on a large scale to the United States and other highly regulated markets. A wave of mergers, acquisitions and tie-ups point to growing integration between Indian firms and global pharma multinationals.

The Politics of the Pharmaceutical Industry and Access to Medicines: World Pharmacy and India examines this important industry from different economic, social and political perspectives. Topics covered include the implications of TRIPS-compliant intellectual property rights, the role of flexibilities under TRIPS, the market regulation system, the role of Indian firms in exporting HIV/AIDS medications to Africa, the issue of free trade agreements, the power and reach of foreign pharmaceutical multinationals in India’s domestic market, and the sustainability of India as a major generics supplier.

The Pharmaceutical Industry and Access to Medicines in India

Pharmaceutical policy in India as elsewhere is shaped by conflicting economic and social interests and opposing values and priorities. Tensions can be understood as revolving around the contradiction between use value and exchange value in the production of medicinal drugs as commodities, as per Marx’s original analysis. The use value of medicines – if safe and efficacious, of good quality, and prescribed and consumed appropriately – is the prevention, cure or alleviation of ill-health and disease. Health policy is – or should be – aimed at optimising the use value of medicines. For this purpose government agencies administer regulatory oversight of the manufacturing, marketing and distribution of medicines. Drugs made available to patients are expected to meet adequate safety, quality and efficacy standards, but regulation to ensure such standards is subject to controversy in most countries. This is a domain where definition and interpretation of scientific-technological principles and criteria is infused by partiality and bias grounded in social and material interests, as evidenced by recurrent debates about industry ‘capture’ of regulatory agencies, including the world’s most regulator, the US Food and Drug Administration (Angell 2005; Law 2006). In India, a Parliamentary Committee Report in 2012 depicted the Central Drugs Standard Control Organisation (CDSCO) as dysfunctional and influenced inappropriately by the exchange value perspective of manufacturers (Parliamentary Standing Committee on Health and Welfare 2012). The clash between use and exchange value perspectives is starkly illustrated by cases of products known to cause more harm than good, particularly common in poorly regulated markets such as India’s, as shown by Srinivasan & Phadke.

The pharmaceutical industry, intellectual property rights and access to medicines in Pakistan

The pharmaceutical industry in Pakistan is worth around US$ l.18 billion, with annual growth in 2010 approaching 10 per cent (Khan, 2012). There are more than 650 registered companies, including 31 multinationals, which in 2006 had a market share in value terms of 53.3 per cent, with national firms controlling the remaining 46.7 per cent (IMS Health, 2007). In 2007 medicines worth about US$100 million were exported. Medicines are a vital component of healthcare, and Pakistan spends around three-quarters of its healthcare budget on medicines (WHO, 2004). This chapter provides an overview, from a public health perspective, of the national pharmaceutical market and the development of drug policies and regulation. Pakistan adopted a Trade Related Aspects of Intellectual Property Rights (TRIPS) compliant patent regime in 2000, and the intersection between patents and public health is a central policy challenge. This chapter highlights key issues related to intellectual property, Free Trade Agreements (FTAs), and production and access to medicines.

Access to Health-Promoting Facilities and Amenities

This chapter provides a brief overview of the existing literature on the importance of the built environment to obesity and examines how local facilities, such as physical activity amenities, are distributed across different sorts of neighbourhoods. The issue of access to these facilities using different forms of transport (walking, cycling, bus or car) is explored using data from a Scotland wide study.

Sociospatial distribution of access to facilities for moderate and vigorous intensity physical activity in Scotland by different modes of transport

Background People living in neighbourhoods of lower socioeconomic status have been shown to have higher rates of obesity and a lower likelihood of meeting physical activity recommendations than their more affluent counterparts. This study examines the sociospatial distribution of access to facilities for moderate or vigorous intensity physical activity in Scotland and whether such access differs by the mode of transport available and by Urban Rural Classification. Methods A database of all fixed physical activity facilities was obtained from the national agency for sport in Scotland. Facilities were categorised into light, moderate and vigorous intensity activity groupings before being mapped. Transport networks were created to assess the number of each type of facility accessible from the population weighted centroid of each small area in Scotland on foot, by bicycle, by car and by bus. Multilevel modelling was used to investigate the distribution of the number of accessible facilities by small area deprivation within urban, small town and rural areas separately, adjusting for population size and local authority. Results Prior to adjustment for Urban Rural Classification and local authority, the median number of accessible facilities for moderate or vigorous intensity activity increased with increasing deprivation from the most affluent or second most affluent quintile to the most deprived for all modes of transport. However, after adjustment, the modelling results suggest that those in more affluent areas have significantly higher access to moderate and vigorous intensity facilities by car than those living in more deprived areas. Conclusions The sociospatial distributions of access to facilities for both moderate intensity and vigorous intensity physical activity were similar. However, the results suggest that those living in the most affluent neighbourhoods have poorer access to facilities of either type that can be reached on foot, by bicycle or by bus than those living in less affluent areas. This poorer access from the most affluent areas appears to be reversed for those with access to a car.

Challenges redoubled: contexts of risk and compromised access to services for children with sexualised behaviours

 Clinical studies indicate that children who engage in coercive or aggressive sexual acts are more likely to come from conditions of developmental adversity. Broadly speaking, the context of risk for children engaging in these behaviours aligns with particular indicators of social exclusion; geographic disadvantage, compromised family functioning and poverty. Children from such conditions of adversity are thought to be doubly compromised, as the context of risk that gave rise to the behaviours may also compromise families’ engagement with specialised therapeutic services to modify a child’s behaviours. In the absence of empirical data on the prevalence of problem sexual behaviours in Australia, this paper suggests that that scholarship and data collection underpinning the social inclusion policy agenda may inform the targeted delivery of secondary prevention strategies for children most at risk of engaging in problem sexual behaviours.

Digital systems for open access to formal and informal learning

 Today, Digital Systems and Services for Technology Supported Learning and Education are recognized as the key drivers to transform the way that individuals, groups and organizations “learn” and the way to “assess learning” in 21st Century. These transformations influence: Objectives - moving from acquiring new “knowledge” to developing new and relevant “competences”; Methods – moving from “classroom” based teaching to “context-aware” personalized learning; and Assessment – moving from “life-long” degrees and certifications to “on-demand” and “in-context” accreditation of qualifications. Within this context, promoting Open Access to Formal and Informal Learning, is currently a key issue in the public discourse and the global dialogue on Education, including Massive Open Online Courses (MOOCs) and Flipped School Classrooms.

Gender, sexuality and embodiment : access to and experience of healthcare by same-sex attracted women in Australia

This article identifies the way same-sex attracted women negotiate healthcare in a rural Australian setting. In-depth interviews were conducted with 10 women. Respondents choose general practitioners (GPs) carefully, `interviewing' them to see if they hold acceptable attitudes to same-sex attraction. However, sexuality is not the only evaluative criteria women use. Some women invoke gender-based discourse, evaluating GPs by how well they treat women's bodies. In other instances, women utilize a framework based on sexuality; good healthcare is associated with how the practitioner dealt with same-sex attraction. Sometimes women evaluated care by reference to a model of the body that did not implicate gender or sexuality and GPs are evaluated on the basis of clinical knowledge. This shows that women do not define themselves in a unitary way in relation to gender or sexuality. They selectively and strategically employ discourses of gender, sexuality and embodiment to structure and evaluate healthcare

The foreign presence in the early-industrial Haut-Rhin, 1820–22 : a short history from the ‘pre-history’ of immigration to France

An attempt to limit the rights of domiciled foreigners in the Alsatian department of the Haut-Rhin in 1821 provides an opportunity to examine the impact of immigration on early-industrial society and shifting perceptions of the place of foreigners in French society in a period often omitted from histories of immigration. New conceptions of belonging become evident, which demonstrate a turn away from local and subjective bonds to community, towards bonds regulated nationally through nationality law. Imposed in an emerging urban, industrial context, the limitations of rights—on access to the biens communaux and the droit d’affouage—were traditional restrictions of rural society and modes of distinguishing the included from the excluded and were imposed on long-settled foreigners who failed to become naturalized as French citizens. The article reflects on the question why, if the concerns about immigration and industrialization turned on recently arrived foreign workers, these traditional exclusions were imposed on established resident foreigners.

Access to social insurance in urban China: a comparative study of rural-urban and urban-urban migrants in Beijing

 Since 1958 the hukou (household registration) system has assigned Chinese citizens either a rural or urban status. Some studies argue that the rural-to-urban migrants in China who do not have urban hukou are not entitled to urban social insurance schemes, due to institutional discrimination, which applies differing treatment to urban and rural hukou (chengxiang fenge). Although rural-urban migrants participate less in the social insurance system than their counterparts with urban hukou, a closer examination of recent policy developments shows that migrants actually do have the legal right to access the system. This implies that discrimination between rural and urban workers has been declining, and distinctions based on household registration status are less able to explain China's current urban transition. This paper provides a new way of examining Chinese migrants' social insurance participation, by adopting a framework that includes both rural-to-urban migrants and urban-to-urban migrants, which are an important, but less studied, migrant group. Among our key findings are that urban migrants are more likely to sign a labour contract than rural migrants; urban migrants have higher participation rates in social insurance than rural migrants; having a labour contract has a greater impact than hukou status in determining whether Beijing's floating population accesses social insurance; and urban migrants who have signed a labour contract have higher participation rates in social insurance than either rural migrants or urban migrants without a labour contract. © 2013 Elsevier Ltd.

Improving Indigenous Access to Early Childhood Services in Urban and Regional Areas

The literature on how to improve Indigenous access to early childhood services consists mainly of program descriptions and documented practice experience, with a limited number of formal program evaluations. Accessible early childhood services fulfil four overlapping dimensions. They are physically accessible; economically accessible (affordable); appropriate (comprehensive and non-discriminatory); and acceptable (respect and acknowledge culture).The literature suggests that there are five types of barriers to accessible early childhood services: individual; program; provider; social and neighbourhood; and cultural.It is not sufficient to just improve access—engagement strategies are also necessary to get families involved in the services that may benefit them.