Outsourcing the risks : alcohol licensing, risk and the making of the night time economy

Mariana Valverde argues that in the late twentieth century, the British state contracted out the prevention of disorder and monitoring of risks produced by widespread alcohol use to the private sector through the process of liquor licensing. This paper will argue that this scenario was duplicated in Victoria at the same time. It will do so by an analysis of four government-instigated inquiries into liquor licensing regimes from 1965 to 1998. The inquiries were distinguished by the subtly different emphases in their terms of reference. In 1965, the Phillips Royal Commission was directed to inquire into the best ways of dealing with the problems alcohol produced and how best to regulate it for the benefit of the population as a whole. By the time the Nieuwenhuysen Report was commissioned in 1985, the emphasis had changed, and he was directed to inquire how best to serve the interests of alcohol consumers and to produce the licensing regulatory regime which would enable the construction of a 24-hour city. Any anomalies that still existed in the revised Act were eliminated in the 1998 review which was instigated as a direct response to the National Competition Policy. A consequence of these changes over 30 years was the development of particular risk groups, such as ‘binge-drinking young people’, whose violence and nuisance must be controlled to enable all other ‘reasonable’ and ‘moderate’ drinkers be allowed to keep drinking. Thus the notion of risk had been redefined and the responsibility for dealing with these risks had been directed from the state to individual licensees and individual drinkers.

Everyday risks and professional dilemmas : fieldwork with alcohol-based (sporting) subcultures

This article discusses some of the everyday risks and professional dilemmas encountered when conducting participant-observation based research into the use and meaning of alcohol among fans of Australian Rules football. The key risks and dilemmas were those that emerged from female researchers entering into a predominantly male football subculture in which alcohol is routinely (and often excessively) consumed, the negotiation of key gatekeepers, the potential dangers of conducting research with participants who are inebriated and the duty of care to research participants. The article draws on an eighteen-month period of ethnographic fieldwork to highlight the risks and dilemmas negotiated and re-negotiated throughout the research process. The article argues that a failure to attend to these and other risks and dilemmas can threaten the viability of research among drinking-based communities and subcultures.

A social network analysis model for analysing stakeholder-associated safety risks in infrastructure projects

An important strategy in the long-term blueprint for making Australia's 18 capital and major regional cities more productive, sustainable and liveable is to develop high quality public infrastructure systems to improve civic quality of life. Because of the unique features of construction activities, such as long period, complicated processes, and dynamic organizational structures, infrastructure projects normally involve multiple stakeholders and are subject to various risks, especially safety issues. Any negligence or mismanagement of critical safety risks will have huge impact on achieving project objectives and success. Although many previous studies have identified and assessed various safety risks in construction industry, a main research gap is that these studies ignored a fact that most risks are interrelated and associated with internal and external stakeholders of the projects. The lack of a theoretical foundation and appropriate methods for analysing stakeholder-associated safety risks and their interdependencies in infrastructure projects hinders effective risk management processes and the formulations of decision strategies. This research aims at enabling higher performance in strategic safety risk management in infrastructure projects through the development of a holistic risk analysis model using Stakeholder and Social Network Theories. The outcomes can broaden project managers' awareness of emerging influential safety risks and enhance their ability to perceive, understand, assess, and mitigate safety risks in an effective and efficient way; thereby higher performance in strategic risk management could be achieved in infrastructure projects.

The use of complementary and alternative medicine among people living with diabetes in Sydney

Background: Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature.

Methods: A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed.

Results: Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044).

Conclusions: Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage.

Balancing the benefits and risks of public–private partnerships to address the global double burden of malnutrition

Objective: Transnational food, beverage and restaurant companies, and their corporate foundations, may be potential collaborators to help address complex public health nutrition challenges. While UN system guidelines are available for private-sector engagement, non-governmental organizations (NGO) have limited guidelines to navigate diverse opportunities and challenges presented by partnering with these companies through public–private partnerships (PPP) to address the global double burden of malnutrition.

Design: We conducted a search of electronic databases, UN system websites and grey literature to identify resources about partnerships used to address the global double burden of malnutrition. A narrative summary provides a synthesis of the interdisciplinary literature identified.

Results: We describe partnership opportunities, benefits and challenges; and tools and approaches to help NGO engage with the private sector to address global public health nutrition challenges. PPP benefits include: raising the visibility of nutrition and health on policy agendas; mobilizing funds and advocating for research; strengthening food-system processes and delivery systems; facilitating technology transfer; and expanding access to medications, vaccines, healthy food and beverage products, and nutrition assistance during humanitarian crises. PPP challenges include: balancing private commercial interests with public health interests; managing conflicts of interest; ensuring that co-branded activities support healthy products and healthy eating environments; complying with ethical codes of conduct; assessing partnership compatibility; and evaluating partnership outcomes.

Conclusions: NGO should adopt a systematic and transparent approach using available tools and processes to maximize benefits and minimize risks of partnering with transnational food, beverage and restaurant companies to effectively target the global double burden of malnutrition.

Randomised controlled trials and 'unexpected' adverse events associated with newly released drugs : improvements in pharmacovigilance systems are necessary for real-time identification of patient safety risks

Adverse drug events are one of the major causes of morbidity in developed countries, yet the drugs involved in these events have been trialled and approved on the basis of randomised controlled trials (RCTs), regarded as the study design that will produce the best evidence.

Though the focus on adverse drug events has been primarily on processes and outcomes associated with the use of these approved drugs, attention needs to be directed to the way in which the RCT study design is structured. The implementation of controls to achieve internal validity in RCTs may be the very controls that reduce external validity, and contribute to the levels of adverse drug events associated with the release of a new drug to the wider patient population.

An examination of these controls, and the effects they can have on patient safety, underscore the importance of knowing about how the clinical trials of a drug are undertaken, rather than relying only on the recorded outcomes.

As the majority of new drugs are likely to be prescribed to older patients who have one or more comorbidities in addition to that targeted by a new drug, and as the RCTs of those drugs typically under-represent the elderly and exclude patients with multiple comorbidities, timely assessment of drug safety signals is essential.

It is unlikely that regulatory jurisdictions will undertake a reassessment of safety issues for drugs that are already approved. Instead, reliance has been placed on adverse drug event reporting systems. Such systems have a very low reporting rate, and most adverse drug events remain unreported, to the eventual cost to patients and healthcare systems.

This makes it essential for near real-time systems that can pick up safety signals as they occur, so that modifications to the product information (or removal of the drug) can be implemented.

The challenges and risks of measuring performance in a social learning system

This submission draws attention to the challenges of modelling and measuring teacher performance and the risks associated with the measurement of student and teacher performance. The first premise of this submission is that all such performances are strongly contextual, and that therefore valid modelling and measurement must take the effective dimensions of this context into account. The second premise of this submission is that this performance-context nexus operates as a system and that one of the properties of such systems is continuous feedback looping. The submission draws attention as well to an important entailment of this argument, which is that invalid modelling and measurement may lead to a distortion of the productive functioning of learning systems. This submission accordingly urges the Commission to commit to developing an econometric model which reckons with the contextual determinants of student and teacher performance, and the pursuit of system-wide productivity increases on the basis of the school learning system as the basic unit of analysis. The Commission is also urged to investigate the suggestion that performance measurement regimes which take the basic units of measurement as individual student and teacher performance rather than the school pose a risk to the productivity of schools as learning systems and innovation in the Australian economy as a whole in the longer term.

Building online brand communities : exploring the benefits, challenges and risks in the Australian event sector

The Internet has impacted the tourism sector and tourists substantially. Yet, very little information is known about how tourism organisations are using the second generation of the Internet, Web 2.0, and its various social media platforms in relation to their marketing activities. This article explores ways in which events, as an integral part of the tourism sector, are using Web 2.0 tools to build their online brand communities. While the qualitative analysis highlights benefits for events, it also identifies the risks and challenges that events face in using Web 2.0. These include the capacity to resource this aspect of marketing and the ability to protect their brand from the advent of counter- and alter-brand communities when online brand community building activities are not fully effective.

Multiple identification and risks : examination of peer factors across multiracial and single-race youth

Multiracial youth are thought to be more vulnerable to peer-related risk factors than are single-race youth. However, there have been surprisingly few well-designed studies on this topic. This study empirically investigated the extent to which multiracial youth are at higher risk for peer influenced problem behavior. Data are from a representative and longitudinal sample of youth from Washington State (N = 1,760, mean age = 14.13, 50.9% girls). Of those in the sample, 225 youth self-identified as multiracial (12.8%), 1,259 as White (71.5%), 152 as Latino (8.6%), and 124 as Asian American (7.1%). Results show that multiracial youth have higher rates of violence and alcohol use than Whites and more marijuana use than Asian Americans. Higher levels of socioeconomic disadvantage and single-parent family status partly explained the higher rates of problem behaviors among multiracial youth. Peer risk factors of substance-using or antisocial friends were higher for multiracial youth than Whites, even after socioeconomic variables were accounted for, demonstrating a higher rate of peer risks among multiracial youth. The number of substance-using friends was the most consistently significant correlate and predictor of problems and was highest among multiracial youth. However, interaction tests did not provide consistent evidence of a stronger influence of peer risks among multiracial youth. Findings underscore the importance of a differentiated understanding of vulnerability in order to better target prevention and intervention efforts as well as the need for further research that can help identify and explain the unique experiences and vulnerabilities of multiracial youth.