Is privatisation good for investment in Australia?

Privatisation was expected to promote investment in the economy as part of improving dynamic efficiency. The relation between aggregate public and private investment in Australia is investigated in an endogeneous ECM framework. Model selection for a simple investment function allows restrictions for neoclassical crowding out or Keynesian crowding in (after Aschauer 1989) in a small open economy. An ECM is estimated including annual aggregate private investment, public investment, income, rate of return, average interest cost, exchange rate and inventories from 1960 to 2005. Public capital appears unresponsive to shocks and crowding out is not evident.

Assessing patient satisfaction with day surgery at a metropolitan public hospital

With the advances in health care technology, many surgical procedures are performed as day surgery cases. The provision of day surgery is considered to be a cost effective method of utilising resources, but it does challenge nurses to provide optimal patient care during the patient's short stay in hospital. Patient satisfaction is considered to be an important indicator of quality nursing care. This paper reports on an investigation aimed at assessing patient satisfaction with day surgery in an Australian metropolitan public hospital. One hundred and seven patients completed a recently developed survey assessing patient satisfaction with day surgery. The response rate was 41%. Waiting times, communication, pain management and discharge planning were major areas of patient dissatisfaction. Directions for improvement in day surgery services are discussed.

The role of the print media in informing the community about safety in public hospitals in Victoria, Australia: the case of `golden staph`

Objective. In this article the authors explore how the print media contribute to information and education of the community on issues of safety and quality in the health services, since this is an important avenue of such information and education for many members of the community. Study design. The authors undertook a qualitative study of a random sample of articles in the Australian print press between 1996 and 2004 where ‘golden staph’ was presented as a major issue of risk to the safety of consumers of health services. The content of each article was examined with reference to several criteria including title, the source of the article, and the metaphorical language employed by the journalist.
Results. Results show that while the articles are substantially accurate as sources of information on concrete events, they do not serve as sources of education on issues of safety, typically apportioning blame and serving to maintain the status quo.
Conclusion. The authors conclude that print media are not a good source of community education in areas of safety and quality and do not assist members of the community to participate in addressing issues of safety in health services.

Food and move project, promoting healthy eating & physical activity in a secondary school setting, pat 1: baseline data, interventions and future recommendations

The Food and Move project was a collaborative project with the students, staff and parents from four Warrnambool secondary colleges which focussed on promoting healthy eating and physical activity in secondary schools and built capacity for ongoing health promotion to address overweight/obesity.

The project aimed to:

1. Increase awareness amongst students, parents and staff of the links between regular physical activity and good nutrition to achieve optimal health.
2. Increase awareness amongst students, parents and staff of childhood/adolescent obesity and its implications for future health.
3. Improve the opportunities for students to access healthy food at their school canteen.
4. Improve the opportunities for students to access physical activity at recess and lunchtime.
5. Prepare a resource package of initiatives for use in secondary colleges to support the provision of opportunities for healthy eating and physical activity at Warrnambool secondary colleges.
6. Support the development of appropriate physical activity and nutrition curricula.

'I know I'm doing a good job': canonical and autobiographical narratives of teenage mothers

Teenage pregnancy is typically presented as a problem to be solved, if not as an epidemic in need of urgent intervention. This paper reports on Australian research that examined the phenomenon of teenage motherhood from the perspective of the young women themselves. The theoretical frame of narrative was adopted in order to understand both the way in which the young mothers were making sense of their own lives, and the way in which they interpreted the canonical narrative of teenage motherhood. Interviews with 20 young mothers demonstrated both their awareness of the canonical narrative, in which they are judged and condemned, and their contrasting autobiographical narratives, in which they are represented as good mothers who are capable of learning the skills of motherhood. Although the women refused to emphasise the disadvantages of teenage motherhood, they acknowledged difficulties. Throughout their autobiographical accounts, a 'consoling plot' was evident. Young women may be supported in their endeavour to emplot their lives to their own benefit by family narratives of teenage motherhood.

People, places and public health : evaluating the benefits of civic environmentalism in an urban local government context

Recent political, economic and social trends pose threats to the sustainability both of ecosystems and of human health. Australia’s environmental management record is poor, and while by international standards Australians enjoy good health, this is variable (AIHW, 2000). Within developed nations, heart disease, depression, alcohol dependence and stroke are major health issues (Mathers et al. 2002). In Australia, mental disorder is the number one contributor to the disease burden (Vos & Mathers 2000). Recent research has highlighted the role of social capital as a key determinant of health (Kawachi et al., 1997). Despite this, Putnam (1995) observes that social connectedness and civic engagement are in decline. People have less time for leisure and for volunteering, as many juggle paid work and caring for children. Anecdotal evidence suggests that engagement in civic environmentalism has human health benefits, relating to a combination of exposure to natural environments and increased social capital (Maller, Brown, Townsend & St. Leger, 2002). This link is supported by Furnass (1996) who defines well-being as including: satisfactory human relationships, meaningful occupation, opportunities for contact with nature, creative expression, and making a positive contribution to human society. Research conducted by Deakin University confirms the efficacy of linking people and places through civic environmentalism for addressing both ecosystem sustainability and human health and wellbeing. The research has included a pilot study to explore the human health benefits of membership of a local parkland ‘Friends’ group, and a more detailed follow-up study. The aims of the pilot study included:- To identify the range of motivations for joining the Friends group;- To document members’ perceptions of the benefits gained from membership of the group;- To assess the potential for Friends groups to be used as an ‘upstream’ health promotion measure.Face-to-face interviews were conducted with eleven members of a ‘Friends’ group in the eastern suburbs of Melbourne. Data was analysed thematically and key findings included:- Motivations: environmental; social; and pragmatic.- General benefits: community belonging; personal satisfaction; learning opportunities; physical activity; and better environment.- Health benefits: physical health; mental health; and social support. There was unanimous support for the use of ‘Friends’ groups as a tool for health promotion.The follow-up study, in the western suburbs of Melbourne, expanded on the pilot study by measuring the group’s social capital and by collecting self-report data on levels of health service usage. Data was collected through face-to-face interviews and a questionnaire. The findings were similar to the pilot study in relation to the motivations, benefits and the health promotion potential of such groups. However, health service usage data highlighted an apparent anomaly: while respondents perceived significant health benefits, some were nevertheless utilising health services at a relatively high level. This poses some questions requiring further exploration: Is this due to the poorer baseline health of the high health service usage members compared with their fellow members? Does involvement in the group offer health benefits that enable people who would otherwise be too unhealthy to participate in community groups to continue such involvement?If this is the case, then we may do well to look to locally-based mechanisms for promoting ecological sustainability as a tool also for promoting human health. Instead of prescribing a pill, connecting people and places through engagement with a local friends group may address our health problems at the same time as addressing local environmental problems.

Are the potential benefits of a community-based participatory approach to public health research worth the potential cost?

Much of public health research is conducted in a community setting or is designed to target particular population groups. Community-based participatory research (CBPR) is gaining recognition as good practice in studies of this type(Flicker et al 2007). Its merit is based on the inclusion of the community as active participants at all stages of the research process (Goodman 2006). The focus on justice and equity in this approach is seen to contribute to a range of additional potential research benefits including increased relevance and sustainability of interventions arising from the research ( Blumenthal 2004; Wallestein 2006) However, it is widely acknowledged that adoption of a consciously CBPR approach requires additional expertise. time and resources from researchers and from communities (Tanjasiri et al 2002; Massaro & Claiborne 2001; Israel et al 1998). Adoption of CBPR is also limited by existing infrastructures which are supportive of more· traditional models of research. Changes to professional development programs, funding guidelines and criteria. grant review processes and ethics requirements are needed to support increased application of this approach (Israel et al 2001). As all research resources are limited, the potential additional benefits offered by CBPR over and above a more traditional research approach need to be weighed against the potential additional costs involved. Changes to research infrastructure are unlikely to occur until the costs and
benefits of a consciously CBPR approach as compared to a more traditional research approach can be demonstrated.

This is an exploratory paper that summarises the arguments put forward to date in relation to CBPR. A research case study and an evaluation framework are then used for a conceptual analysis of differences in the potential costs and benefits of the two approaches. Firstly, the paper describes the differences between traditional and consciously CBPR approaches. The reported benefits of CBPR are then outlined, followed by a discussion of the potential costs. Finally, the potential costs are compared to the potential benefits of using a CBPR approach, using a case study of existing research.

Can universities be good corporate citizens?

As universities respond to a prolonged period of economic rationalism there appears to be resignation, for the most part, that the role of a university is not what it once was. By adopting the operational strictures of economy, efficiency and performance, many universities are behaving like and being run as though they were a business. The term ‘corporate university’ now carries much meaning and has been the subject of significant discourse over the last decade. Resource limitations, political influences and competitive pressures are commonplace with implications for the way in which a university can fulfil a role in society, however that is defined. In this paper we consider the notion of corporate citizenship and ask whether this concept is relevant to the role of a university in Australia and New Zealand. In these countries universities are substantially (although progressively less so) funded by the government and are public service entities. The application of corporate citizenship to universities serves to highlight the duality of these institutions, which operate like corporations, and yet have more obvious historically based obligations to society. The comparison also suggests that as corporations are becoming more aware of the long-term benefits of a societal role for business entities that universities appear to be moving in the opposite direction. With a few exceptions academics have been reluctant to engage in public debates. They have progressively lost control of their working environment. The risk is that the public interest will have no place in the corporatised university of the 21st century unless academics increase their critic and conscience activities.

Are youth mentoring programs good value-for-money? An evaluation of the Big Brothers Big Sisters Melbourne program

Background : The Big Brothers Big Sisters (BBBS) program matches vulnerable young people with a trained, supervised adult volunteer as mentor. The young people are typically seriously disadvantaged, with multiple psychosocial problems.

Methods : Threshold analysis was undertaken to determine whether investment in the program was a worthwhile use of limited public funds. The potential cost savings were based on US estimates of life-time costs associated with high-risk youth who drop out-of-school and become adult criminals. The intervention was modelled for children aged 10–14 years residing in Melbourne in 2004.

Results : If the program serviced 2,208 of the most vulnerable young people, it would cost AUD 39.5 M. Assuming 50% were high-risk, the associated costs of their adult criminality would be AUD 3.3 billion. To break even, the program would need to avert high-risk behaviours in only 1.3% (14/1,104) of participants.

Conclusion : This indicative evaluation suggests that the BBBS program represents excellent 'value for money'.

Communicating climate change: public responsiveness and matters of concern

Since climate change captured global attention in the 1990s, the private individual, addressed as a member of a concerned public, has occupied a focal position in the discourse of environmental amelioration. Recently, a range of prominent books, films and television programs — for example, Tim Flannery’s The Weather Makers (2005), Al Gore’s An Inconvenient Truth (2006) and ABC TV’s Carbon Cops (2007) — have promoted the role of the individual as the ‘starting point’ for effective environmental action. These texts assume that the provision and comprehension of sufficient information to the public about climate change will change individual habits and practices. This accords with the ‘information-deficit model’ in environmental communication research, a concept that asserts a direct connection between individual awareness and response, and collective action. This paper discusses the limitations of this model, pervasive in both popular and official approaches to climate change. It will interrogate the philosophical assumptions that underlie it, in which nature and culture are polarised and the human is positioned in a certain, and separate, relationship to the non-human world — an inheritance of the very logic that enables the continued exploitation of nature. Applying Bruno Latour’s notion of a ‘matter of concern’ to climate change, where the gathering of a range of irreducible forces and im/materialities continually produce these phenomena, this paper proposes that, in thinking about climate change as essentially unrepresentable, a different mode of public engagement with the issue is asserted.

Quality of occupational health provision: two rating scales and their determinants

Background To develop quality scales for occupational health services (OHSs) and describe and explain variation in quality across the UK university sector.

Methods Analysis of data from a national survey, to which 93 of 117 (79%) UK universities responded, and from the Higher Education Statistics Agency. Two quality scales were generated, one from the 1985 International Labour Organization recommendations on OHSs and one from clinicians’ perceptions (good, adequate, poor) about their OHS. The determinants examined were number of university staff, type of OHS (in-house, contracted, none/other), number of full-time equivalent occupational health doctors and nurses and OHS leadership (doctor, nurse, other).

Results There was wide variation in quality and a correlation (r = 0.65) between scales. In-house service, increasing service size and leadership by a doctor or nurse were determinants of higher quality; size of the university was not statistically significant after taking account of these factors.

Conclusions Some university OHSs may not be structured or operated to promote the highest quality of service. Inspection of individual quality scale items may be informative. These scales may be applicable in other employment sectors.

Occupational health services in higher education : third annual report

Occupational health services can make a valuable contribution to the performance of HEIs, yet a pilot study in 1999 suggested that occupational health provision in the HE sector lags behind other sectors, with some noticeable gaps. This project will:

* survey all UK HEIs to establish a baseline and identify examples of good practice in occupational health provision
* disseminate benchmarking information and case studies
* establish a collaborative network to encourage the development, sharing and implementation of recognised good practice and ensure the sustainability of improvements resulting from the project
* evaluate the outcomes of the above work.

Writing public space : design, philosophy, art

Among the factors explaining the emotional poverty of contemporary urban spaces is the dissociation of those who think, design and adorn them. Using his experience in designing high profile public artworks in Australia, notably Relay (Homebush Bay, Sydney, 2000 Olympics), Nearamnew (Federation Square, Melbourne) and Solution (Docklands, Melbourne), Paul Carter argues that a new dialogue between designers, philosophers and artists is urgently needed. The basis of this dialogue will be an expanded notion of graphicality, a new engagement with the discursive character of public space, and the evolution of postrepresentationalist art practices that make surface the psychic violence and cultural waste involved in the provision of new functionallydefined “places”. This paper traverses a number of projects: Relay (1998‑2000), Nearamnew (1998‑2003), Solution (2002), Save the Wall (2004‑) Golden Grove (2004‑).

Working together : collaboration between midwives and doctors in public hospitals

While collaborative, multidisciplinary teamwork is widely espoused as the goal of contemporary hospitals, it is hard to achieve. In maternity care especially, professional rivalries and deep-seated philosophical differences over childbirth generate significant tensions. This article draws on qualitative research in several Victorian public maternity units to consider the challenges to inter-professional collaboration. It reports what doctors and midwives looked for in colleagues they liked to work with — the attributes of a “good doctor” or a “good midwife”. Although their ideals did not entirely match, both groups respected skill and hard work and sought mutual trust, respect and accountability. Yet effective working together is limited both by tensions over role boundaries and power and by incivility that is intensified by increasing workloads and a fragmented labour force. The skills and qualities that form the basis of “professional courtesy” need to be recognised as Aust Health Rev 2009: 33(2): 315–324 essential to good collaborative practice.

Modelling the public health consequences of cannabis use in Australia

Aims: To detail and validate a simulation model that describes the dynamics of cannabis use, including its probable causal relationships with schizophrenia, road traffic accidents (RTA) and heroin/poly-drug use (HPU).

Methods: A Markov model with 17 health-states was constructed. Annual cycles were used to simulate the initiation of cannabis use, progression in use, reduction and complete remission. The probabilities of transition between health-states were derived from observational data. Following 10-year-old Australian children for 90 years, the model estimated age-specific prevalence for cannabis use. By applying the relative risks according to the extent of cannabis use, the age-specific prevalence of schizophrenia and HPU, and the annual RTA incidence and fatality rate were also estimated. Predictive validity of the model was tested by comparing modelled outputs with data from other credible sources. Sensitivity and scenario analyses were conducted to evaluate technical validity and face validity.

Results: The estimated cannabis use prevalence in individuals aged 10-65 years was 12.2% which comprised 27.4% weekly and 18.0% daily users. The modelled prevalence and age profile were comparable to the reported cross-sectional data. The model also provided good approximations to the prevalence of schizophrenia (Modelled: 4.75/1,000 persons vs Observed: 4.6/1,000 persons), HPU (3.2/1,000 vs 3.1/1,000) and the RTA fatality rate (8.1 per 100,000 vs 8.2 per 100,000). Sensitivity analyses and scenario analysis provided expected and explainable trends.

Conclusions: The validated model provides a valuable tool to assess the likely effectiveness and cost-effectiveness of interventions designed to affect patterns of cannabis use. It can be updated as new data becomes available and/or applied to other countries.