The cost of healthcare for children with mental health difficulties

Objective: Childhood mental health difficulties affect one in every seven children in Australia, posing a potential financial burden to society. This paper reports on the early lifetime individual and population non-hospital healthcare costs to the Australian Federal Government for children experiencing mental health difficulties. It also reports on the use and cost of particular categories of service use, including the Medicare Benefits Schedule (MBS) mental health items introduced in 2006.

Ways in which theory and practice are integrated in the pre-service teacher education practicum

This paper reports on a study into pre-service teachers’ perceptions about their professional development during practicum. The study examined to what extent, and how effectively, one group of pre-service teachers was able to integrate theory and practice during a three-week practicum in the first year of their degree. Data for this mixed methods study were drawn from one cohort of first-year students undertaking the Master of Teaching (MTeach), a graduate-level entry program in the Faculty of Education at an urban Australian university. Although there is a strong field of literature around the practicum in pre-service teacher education, there has been a limited focus on how pre-service teachers themselves perceive their development during this learning period. Further, despite widespread and longstanding acknowledgement of the “gap” between theory and practice in teacher education, there is still more to learn about how well the practicum enables an integration of these two dimensions of teacher preparation. In presenting three major findings of the study, this paper goes some way in addressing these shortcomings in the literature. First, opportunities to integrate theory and practice were varied, with many participants reporting supervision and scheduling issues as impacting on their capacity to effectively enact theory in practice. Second, participants’ privileging of theory over practice, identified previously in the literature as commonly characteristic of the pre-service teacher, was found in this study to be particularly prevalent during practicum. Third, participants overwhelmingly supported the notion of linking university coursework assessment to the practicum as a means of bridging the gap between, on the one hand, the university and the school and, on the other hand, theory and practice. The discussion and consideration of findings such as those reported in this paper are pertinent and timely, given the ratification of both the National Professional Standards for Teachers and the Initial Teacher Education Program Standards by the Australian Federal Government earlier this year. Within a number of the seven Professional Standards, graduate teachers are required to demonstrate knowledge and skills associated with both the theory and practice of teaching and with their effective integration in the classroom. To be nationally accredited, pre-service teacher education programs must provide evidence of enabling pre-service teachers to acquire such knowledge and skills.

Intervention efficacy among 'At Risk' adolescents: a test of subjective wellbeing homeostasis theory

 This study tests a number of theoretical predictions based on subjective wellbeing (SWB) Homeostasis Theory. This theory proposes that SWB is actively maintained and defended within a narrow, positive range of values around a 'set-point' for each person. Due to homeostatic control, it is predicted to be very difficult to substantially increase SWB in samples operating normally within their set-point-range. However, under conditions of homeostatic defeat, where SWB is lower than normal, successful interventions should be accompanied by a substantial increase as each person's SWB returns to lie within its normal range of values. This study tests these propositions using a sample of 4,243 participants in an Australian Federal Government Program for 'at-risk' adolescents. SWB was measured using the Personal Wellbeing Index and results are converted to a metric ranging from 0 to 100 points. The sample was divided into three sub-groups as 0-50, 51-69, and 70+ points. The theoretical prediction was confirmed. The largest post-intervention increase in SWB was in the 0-50 group and lowest in the 70+ group. However, a small increase in SWB was observed in the normal group, which was significant due to the large sample size. The implications of these findings for governments, schools and policy makers are discussed.

Closing the emergency facility: Moving schools from literacy triage to better literacy outcomes

This article focuses on the tensions between national and international testing, educational policy and professionalism for middle school English teachers. I argue that state and federal government(s) are responding to the impact of Australia's falling results on the international testing in PISA (Programme for International Student Assessment) through the usage of their own testing program, the National Assessment Program for Literacy and Numeracy (NAPLAN). The publication of NAPLAN results on the MySchool website in a searchable and comparable form has been detrimental to many schools and has pushed these schools into "emergency mode", as they struggle to improve their scores. At the same time, the results from recent PISA examinations reveal extensive inequities in educational outcomes across Australia, as well as some consistent general trends in the Australian data. I use the metaphor of the hospital emergency department to explore this situation. Drawing on Sahlberg's (2011) notion of the Global Educational Reform Movement (GERM), I explore this metaphor becoming a pandemic. I draw on Gillborn and Youdell's (2000) usage of educational triage and cast different and multiple educational professionals playing the role of the triage nurse-the alternate federal and state government education ministers responding to international and state test results in triage; and principals of poor performing schools operating their school as though it is an emergency department; poor literacy results triaged Code Red receiving immediate focus and attention, but "treated" in terms of immediate survival and a focus on basic skills. I argue that the international testing provides better markers for how we are doing as a nation, and what might be done to improve our international standing with respect to our literacy scores. I argue that true gains in literacy and the development of more complex literacy skills are not made through triaging literacy through an emergency department, but through a long-term focus on school redesign.

e-Mental health for mood and anxiety disorders in general practice

Background Australia is a world leader in the development of internetdelivered programs for the prevention and management of mood and anxiety disorders. Despite a strong evidence base of time- and cost-effectiveness, as well as clinical efficacy, the uptake of these programs in general practice remains low. Objective To familiarise general practitioners (GPs) with the range of online programs in Australia that have demonstrated efficacy and are currently available for use by patients with mental health problems. Discussion E-mental health programs provide an efficacious and accessible form of mental healthcare and have the potential to fill the gap for those for whom such care is inaccessible, unaffordable or unacceptable. Clinicians can also use it in a stepped-care manner to augment existing healthcare services. There are a number of online resources currently available to Australians who have mood or anxiety disorders. These resources have strong evidence to support their effectiveness. Online portals facilitate access to these programs. Recently the Australian Federal Government has funded an education program (eMHPrac) for GPs and mental health professionals, to outline what is available, indicate situations where recommending such resources is appropriate, and suggest ways in which they can be incorporated into general practice.

Applying classification controls to internet content in Australia

Purpose – The purpose of this study is to explore Australian public and stakeholders views towards the regulation of the Internet and its content. The federal government called for submissions addressing their proposal, and this paper analyses these submissions for themes and provides clarity as to the Australian public and stakeholders key concerns in regards to the proposed policy. Design/methodology/approach – The paper uses a qualitative approach to analyse the public consultations to the Australian Federal Government. These documents are coded and analysed to determine negative and positive viewpoints. Findings – The research has shown, based upon the analysis of the consultation, that there was no public support for any of the measures put forward, that the Australian Federal Government in its response has not recognised this public feedback and instead has only utilised some of the qualitative feedback obtained through the public consultation process to try to justify its case to proceed with its proposals. Research limitations/implications – The study is focussed on Australia. Practical implications – The paper analyses a proposed national approach to filtering the content of the Internet and discussed the public reaction to such an approach. Social implications – The paper looks at how different parts of Australian society view Internet filtering in a positive or negative manner. Originality/value – The only study that directly looks at the viewpoint of the Australian public.

Education revolution or just plain revolting? Aboriginal prisoner education in Western Australia

The current Australian Federal government has voiced a commitment to an 'education revolution' and set targets for 'closing the gap' in education attainment for Aboriginal people. Unfortunately, this revolution appears to have bypassed prison education altogether with no mention of it in the publicly available policy documents. This is regrettable given the large numbers of Aboriginal people in custody and begs the question 'Are our incarcerated Indigenous citizens going to be excluded from any potential benefit of the 'revolution'?'

Health-care costs of underweight, overweight and obesity: Australian population-based study

AIM: Child health varies with body mass index (BMI), but it is unknown by what age or how much this attracts additional population health-care costs. We aimed to determine the (1) cross-sectional relationships between BMI and costs across the first decade of life and (2) in longitudinal analyses, whether costs increase with duration of underweight or obesity. METHODS: Participants: Baby (n = 4230) and Kindergarten (n = 4543) cohorts in the nationally representative Longitudinal Study of Australian Children. OUTCOME: Medicare Benefits Scheme (including all general practitioner plus a large proportion of paediatrician visits) plus prescription medication costs to federal government from birth to sixth (Baby cohort) and fourth to tenth (Kindergarten cohort) birthdays. PREDICTOR: biennial BMI measurements over the same period. RESULTS: Among Australian children under 10 years of age, 5-6% were underweight, 11-18% overweight and 5-6% obese. Excess costs with low and high BMI became evident from age 4-5 years, with normal weight accruing the least, obesity the most, and underweight and overweight intermediate costs. Relative to overall between-child variation, these excess costs per child were very modest, with a maximum of $94 per year at age 4-5 years. Nonetheless, this projects to a substantial cost to government of approximately $13 million per annum for all Australian children aged less than 10 years. CONCLUSIONS: Substantial excess population costs provide further economic justification for promoting healthy body weight. However, obese children's low individual excess health-care costs mean that effective treatments are likely to increase short-term costs to the public health purse during childhood.

Salt reduction in Australia: from advocacy to action

BACKGROUND: As part of its endorsement of the World Health Organization's Global Action Plan to prevent non-communicable diseases, the Federal Government of Australia has committed to a 30% reduction in average population salt intake by 2025. Currently, mean daily salt intake levels are 8-9 g, varying by sex, region and population group. A number of salt reduction initiatives have been established over the last decade, but key elements for a co-ordinated population-level strategy are still missing. The objective of this review is to provide a comprehensive overview of existing population-level salt reduction activities in Australia and identify opportunities for further action.

METHODS: A review of the published literature and stakeholder activities was undertaken to identify and document current activities. The activities were then assessed against a pre-defined framework for salt reduction strategies.

RESULTS: A range of initiatives were identified from the review. The Australian Division of World Action on Salt and Health (AWASH) was established in 2005 and in 2007 launched its Drop the Salt! Campaign. This united non-governmental organisations (NGOs), health and medical and food industry organisations in a co-ordinated advocacy effort to encourage government to develop a national strategy to reduce salt. Subsequently, in 2010 the Federal Government launched its Food and Health Dialogue (FHD) with a remit to improve the health of the food supply in Australia through voluntary partnerships with food industry, government and non-government public health organisations. The focus of the FHD to date has been on voluntary reformulation of foods, primarily through salt reduction targets. More recently, in December 2014, the government's Health Star Rating system was launched. This front of pack labelling scheme uses stars to highlight the nutritional profile of packaged foods. Both government initiatives have clear targets or criteria for industry to meet, however, both are voluntary and the extent of industry uptake is not yet clear. There is also no parallel public awareness campaign to try and influence consumer behaviour relating to salt and no agreed mechanism for monitoring national changes in salt intake. The Victorian Health Promotion Foundation (VicHealth) has recently instigated a State-level partnership to advance action and will launch its strategy in 2015.

CONCLUSIONS: In conclusion, salt reduction activities are currently being implemented through a variety of different programs but additional efforts and more robust national monitoring mechanisms are required to ensure that Australia is on track to achieve the proposed 30% reduction in salt intake within the next decade.

Financial model for investment recovery period in electronic health records implementations

Technology usage for better healthcare delivery is being emphasised in the USA and other advanced nations. Electronic health records (EHR) are being widely seen as improving operational efficiency and reducing medication errors in clinic practices and hospitals. Further, hospitals and clinics stand to gain incentives from the federal government if they implement EHRs and demonstrate meaningful use of EHRs. While numerous other aspects of HER implementations is found in literature, financial models have not been well studied. Before implementing EHR, one must take into consideration investment recovery period considering the costs, savings and possible tax incentives. In this paper, we develop financial model for computing investment recovery period in EHR implementations assuming constant patient visits. We further develop required growth rate formula if investments need to be recovered in fixed number of years. The model is illustrated with numerical example.

The equity raw-score matrix - a multi-dimensional indicator of potential disadvantage in higher education

Issues surrounding student participation, transition, retention and successful completion in higher education are topical. While the Australian federal government has identified broad groupings of under-represented students, these do not shed light on the complexities underlying the issues of the educationally disadvantaged, such as the compounding problems of multiple equity-group membership or the overlay of the acute or chronic effects of equity sub-group membership. This paper details the Equity Raw-Score Matrix. The matrix is a multi-dimensional indicator of potential disadvantage in learners, created for the specific purposes of diagnosing the complexities of educational disadvantage and creating pre-emptive strategies for the participation, transition and retention of students who are disadvantaged. The paper also describes the qualitative research study that was the catalyst for the creation of the matrix.

Migrant youth and social policy in multicultural Australia: exploring cross-cultural networking

This chapter explores the extent to which the direction of Australia’s official multicultural and civic integration policies, reflects the social attitudes and networking practices of migrant youth. The chapter pays particular attention to the Federal Government’s “Anti-Racism Strategy” announced in 2012 as part of its Multicultural Policy. On a theoretical level, direct efforts to mitigate racism have the potential to augment strategies that reaffirm pluralism and address disadvantage often associated with the migrant experience. On an empirical level, it is important to explore the extent to which such top-level discourses have actual founding in the social lives of migrant youth. Therefore this chapter presents the empirical findings of an empirical longitudinal on “Social Networks, Belonging and Active Citizenship among Migrant Youth” (Australian Research Council Linkage project 2009–2013). Migrant youth in this study pointed to a number of instances of racism, which act as significant barriers to cross-cultural networking. Analysis of the data shows, among other things, that there is a persistent tendency among migrant youth to point to their social distance from the metaphorical “Aussie Aussie” people of Anglo origins who are perceived as symbolising Australia’s mainstream. Such manifestations of racial discrimination preclude the emergence of a genuinely inclusive society that supports and nurtures cultural diversity as a significant part of the Australian national identity, as well as the stated objectives of its social policy repertoire.

Designing a healthy food partnership: lessons from the Australian food and health dialogue

BACKGROUND: Poor diets are a leading cause of disease burden worldwide. In Australia, the Federal Government established the Food and Health Dialogue (the Dialogue) in 2009 to address this issue, primarily through food reformulation. We evaluated the Dialogue's performance over its 6 years of operation and used these findings to develop recommendations for the success of the new Healthy Food Partnership.

METHODS: We used information from the Dialogue website, media releases, communiqués, e-newsletters, materials released under freedom-of-information, and Parliamentary Hansard to evaluate the Dialogue's achievements from October 2013 to November 2015, using the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework. We also engaged closely with two former Dialogue members. Our findings update a prior assessment done in October 2013.

RESULTS: Little data is available to evaluate the Dialogue's recent achievements, with no information about progress against milestones released since October 2013. In the last 2 years, only one additional set of sodium reduction targets (cheese) was agreed and Quick Service Restaurant foods were added as an area for action. Some activity was identified in 12 of a possible 137 (9 %) areas of action within the Dialogue's mandate. Independent evaluation found targets were partially achieved in some food categories, with substantial variation in success between companies. No effects on the knowledge, behaviours or nutrient intake of the Australian population or evidence of impact on diet-related disease could be identified.

CONCLUSIONS: The new Healthy Food Partnership has similar goals to the Dialogue. While highly laudable and recognised globally as cost-effective, the mechanism for delivery in Australia has been woefully inadequate. Strong government leadership, adequate funding, clear targets and timelines, management of conflict of interest, comprehensive monitoring and evaluation, and a plan for responsive regulation in the event of missed milestones will be required if the new Healthy Food Partnership is to achieve its urgent public health goals.

Reforms required to the Australian tax system to improve biodiversity conservation on private land

Private land conservation forms an integral part of Australia’s natural resource management and biodiversity conservation efforts, and the past two decades have seen a significant growth in the establishment of in-perpetuity conservation covenants. Specifically, conservation covenants address key national goals such as building the National Reserve System and expanding the markets for ecosystem services. However, a number of financial barriers exist to achieving these goals, and the national tax review in the form of the Tax White Paper Task Force provides an opportunity to address these barriers. This article provides a number of specific recommendations which outline how these financial barriers for private land conservation might be addressed by the Federal Government.