88 resultados para Human Services


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Since its emergence during the 1980s the idea of sustainability has come to provide the dominant frame within which environmental policy is debated. Thus, for many ‘sustainability’ represents the best way to address the economic, social and environmental effects of the myriad of environmental issues facing human societies, including biodiversity loss, soil erosion, pollution of waterways, ozone depletion and climate change. There are however, widely divergent views advocated as to what sustainability means, which has important implications for how serious environmental issues are understood to be, why they are important, what has caused them, and what needs to be done to address them. Given the diversity of such views, the consequences for policy making, and the likelihood of effective responses being developed, are self evident. Within this context, this thesis investigates the politics of sustainability, focussing particularly on the way in which it is defined, because of the implications this has for the way in which environmental issues are understood and addressed. Following a review of various approaches to analysing environmental policy (traditional, mainstream, ecopolitical and discursive), Norman Fairclough’s approach to discourse analysis (Critical Discourse Analysis) was identified as having particular merit. Fairclough’s approach avoids the assumption that policy issues exist independently of the way they are framed and offers a perspective on discourse that links the social theoretical concerns of Foucault with the micro level concerns of linguistics. It also provides a means for taking environmental policy analysis in directions that that have attracted relatively limited attraction, namely the detailed analysis of the ideological effects of language on environmental policy. In this thesis Fairclough’s approach is used to explore how three storylines of sustainability (sustainable development, environmentally sustainable growth and transforming society) and their associated discourses shaped environmental policy making in Victoria, Australia, between 1999 and 2006. In undertaking this analysis, I examined the political and institutional context informing policy making (social practice); the contested process of text production (discourse practice), and; the detailed wording of a policy text (textual analysis). A major policy statement on environmental sustainability released by the Victorian Government in 2005 is subjected to detailed analysis. Based on the analysis undertaken, the substantive finding from this research is that rather than moving beyond neoliberalism, the Victorian Government embraced an approach to sustainability that was informed by neoliberalism and (weak) ecological modernisation, which constructs sustainability in ways that limit its importance and constrain the types of responses that could be advocated. In doing so, it drew heavily on notions of natural assets and ecosystems services as ways to make sense of the environment and why it is important. The Victorian Government also highlighted that environmental issues are caused by the cumulative effects of individual choices, and emphasized the importance of individual choice and behavioural change as central features of sustainability, while restricting opportunities for more transformative ideas to be heard. The broader conclusion arising from this research is that approaches to environmental policy that rely on neoliberal and (weak) ecological modern discourses are flawed, because, in commodifying nature, limiting the nature and magnitude of change required, and placing responsibility onto individuals they offer a constrained understanding of the challenge of sustainability and what needs to be done about it. The overall contribution made by this research is an improved understanding of the discursive nature of the politics of sustainability and the influence of neoliberalism and ecological modernisation, the use of a methodology that has attracted relatively limited attention within environmental policy (despite its widespread use in other areas of policy) and the documentation of a period of significant environmental policy reform in Victoria.

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Partnerships involving higher education, governments, and industry have been recognised as important vehicles for engaging community, leveraging knowledge, and sharing potential resources. The critical need for these partnerships in rural and regional locations has been of particular note. Partnership evaluation can serve a critical function of informing continuous improvement and may therefore assist the evaluated agencies to work towards responsive transformational change. The ability for a partnership to adapt and change may aid in their sustainability. Despite the potentially important role of partnership evaluation, the development of tools that measure partnership are at an early stage. Partnership evaluation is rarely reflected upon in the published literature. Moreover, benefits and reflections of the efficacy of evaluations 12 months post analysis is rare in the published literature. Therefore, a brief review of partnership approaches and measurement tools are presented. The purpose of this paper is to reflect upon the efficacy of an evaluation conducted 12 months previously of a partnership between Deakin University, the Department of Health and Department of Human Services (Barwon South West Region), known as the Deakin/DH/DHS Strategic Alliance. This case study reviews several tools/metrics utilised. The efficacy of the evaluation tools is discussed. Those metrics, underlying the tools which contributed to positive change in partnerships are discussed.

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A novel rickettsia was detected in Ixodes tasmani ticks collected from Tasmanian devils. A total of 55% were positive for the citrate synthase gene by quantitative PCR. According to current criteria for rickettsia speciation, this new rickettsia qualifies as Candidatus Rickettsia tasmanensis, named after the location of its detection.

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Objective: To document the epidemiology, clinical characteristics and diagnosis of an outbreak of Mycobacterium ulcerans infection (Bairnsdale or Buruli ulcer [BU]) during the period 1998–2006, and compare delays in diagnosis between residents of endemic and non-endemic regions.

Design and setting:
Retrospective case study of patients identified through infectious disease physicians on the Bellarine Peninsula and the Victorian Department of Human Services notifiable diseases database.

Main outcome measures: Description of events leading to diagnosis of BU.

Results: Eighty-five BU patients recalled their experience. Fifty-three patients were older than 60 years, and 61 permanently resided on the Bellarine Peninsula. The onset of symptoms occurred most frequently in mid winter. Twenty-eight patients had lesions on the arm and 51 on the leg. The median time between onset of symptoms and first medical contact was shorter for those living in the endemic area (3.0 weeks; interquartile range [IQR], 1.0–5.0 weeks) compared with non-endemic areas (5.3 weeks; IQR, 2.0–9.5 weeks) (P = 0.05). Patients who resided in the endemic area had a shorter median time from their first medical appointment to diagnosis (1.0 week; IQR, 0.0–3.9 weeks) than those who resided in non-endemic areas (5.0 weeks; IQR, 1.3–8.0 weeks) (P = 0.001).

Conclusion:
Delay in presentation and time to diagnosis of BU are longer in non-endemic than endemic areas. Measures should be taken to raise awareness of the disease in non-endemic areas.

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Background Inadequate sun exposure and dietary vitamin D intake can result in vitamin D insufficiency. However, limited data are available on actual vitamin D status and predictors in healthy individuals in different regions and by season.

Methods
We compared vitamin D status [25-hydroxyvitamin D; 25(OH)D] in people < 60 years of age using data from cross-sectional studies of three regions across Australia: southeast Queensland (27°S; 167 females and 211 males), Geelong region (38°S; 561 females), and Tasmania (43°S; 432 females and 298 males).

Results
The prevalence of vitamin D insufficiency (≤ 50 nmol/L) in women in winter/spring was 40.5% in southeast Queensland, 37.4% in the Geelong region, and 67.3% in Tasmania. Season, simulated maximum daily duration of vitamin D synthesis, and vitamin D effective daily dose each explained around 14% of the variation in 25(OH)D. Although latitude explained only 3.9% of the variation, a decrease in average 25(OH)D of 1.0 (95% confidence interval, 0.7–1.3) nmol/L for every degree increase in latitude may be clinically relevant. In some months, we found a high insufficiency or even deficiency when sun exposure protection would be recommended on the basis of the simulated ultraviolet index.

Conclusion Vitamin D insufficiency is common over a wide latitude range in Australia. Season appears to be more important than latitude, but both accounted for less than one-fifth of the variation in serum 25(OH)D levels, highlighting the importance of behavioral factors. Current sun exposure guidelines do not seem to fully prevent vitamin D insufficiency, and consideration should be given to their modification or to pursuing other means to achieve vitamin D adequacy.

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Purpose – The purpose of this paper is to assess the applicability of relational contract theory in situations where government departments contract with non-government welfare organisations to deliver human service programmes. Its limits are highlighted by an assessment of programmes for domestically violent men that epitomise “management of incomplete contracts” central to the theory.

Design/methodology/approach – The paper is based on an evaluation of contracted-out programmes for perpetrators of domestic violence in Australia that set out to compare and contrast distinct models of service delivery by documenting programme logic, service delivery effectiveness and effects on programme participants. It reflects on the difficulties of monitoring such programmes and considers the implications of this for contracting theory and for human service practice.

Findings – In contrast to critiques of contracting-out in a neo-liberal environment that emphasise how accountability and reporting requirements limit the autonomy of contracted agencies, this paper highlights considerable variation in how programmes were managed and delivered despite standardised service delivery contracts developed by the government department funding the programmes. This leads to a consideration of “incomplete contracts” where service delivery outcomes are hard to measure or there is limited knowledge of the contracted agencies by the contracting government department.

Originality/value – The paper highlights a situation in which the recommendations of relational contracting theory can exacerbate the difficulties of quality assurance rather than minimise them. It then argues a need for workforce development in the government departments and the contracted agencies, to enable a nuanced monitoring of the programmes' service delivery and promotion of quality assurance processes.

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Social work has traditionally attracted a diverse mix of students with varying levels of academic preparedness and practice skill experience. Current trends in higher education indicate the possibility of further challenges for academic staff in social work as universities seek to both widen participation from university graduates and, at the same time, prioritise practice and academic excellence among students. Drawing on reflective journal entries by the author, this paper examines the challenges that social work academics might face in teaching social work practice skills effectively to the increasingly diverse student cohorts enrolled across Bachelor and Masters of Social Work (Qualifying) degrees. The reflective process adopted in this study explores the gaps between the author’s intentions and the reality of the classroom experience. Key observations included language barriers impeding engagement with the material and cultural differences in relating to others and conceptualising practice. These problems were apparent in both the process of delivery (pedagogy) and content (curriculum). The reflective process highlighted the need for further research in order to optimally respond to the diversity in social work education.

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Background: Chronic diseases and impairments are prevalent among older Americans. However, prevalence data for Alaska Native (AN) elders are limited, with estimates usually extrapolated from national studies in which AN elders may not be well-represented. The aim of this study was to describe the prevalence of selected chronic diseases, impairments, and measured medical risk factors among a large community sample of AN elders.

Methods: Design, setting, and participants. A community-based cross-sectional study of baseline information from 656 AN elders aged 55 years or over who participated in the Alaska Education and Research Towards Health (EARTH) Study, March 2004 to August 2006. Measurements. Self-reported lifetime prevalence of 17 doctor-diagnosed chronic diseases, and point prevalence of vision, hearing, oral, and general health impairment were estimated from data collected using audio computer-assisted self-administered questionnaires. In addition, height, weight, blood pressure, fasting blood lipids, and fasting blood glucose levels were measured.

Results: The four most prevalent chronic diseases among AN elders were high blood pressure (55%), arthritis (49%), high cholesterol (42%), and adult bone fracture/break (35%). The median number of chronic diseases reported was three (inter-quartile range, 2 to 5). The prevalence of self-reported vision impairment was 15%, hearing impairment 18%, and having had all natural teeth removed 25%. Almost 50% were obese. High blood pressure (systolic ≥ 140 mm Hg and/or diastolic ≥ 90 mm Hg) was measured in 23%, high low density lipoprotein (LDL) cholesterol (≥ 130 mg/dL) in 39%, and high fasting plasma glucose (> 125 mg/dL) in 9%. Obesity was more prevalent among women than men. There were also significant regional differences in rates of obesity and high LDL cholesterol.

Conclusion: These data may be useful in public health programs and health services planning.

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As the proportion of older adults continues to grow in many Western countries, there are increasing concerns about how to meet their needs. Ensuring social connectedness and inclusion is one way to support older adults’ wellbeing. Online social networking has become common place amongst younger age groups, suggesting its possible usefulness for older adults, in order to combat isolation and loneliness. Some quantitative studies have already explored the amount and degree of online social networking amongst older adults. To add further understanding of how older adults experience social inclusion via the internet, the current qualitative study aimed to explore older adults’ subjective experience of online social networking. Findings demonstrated a number of supports and barriers to social inclusion which reflect barriers to social inclusion of older adults in the non-virtual world. Recommendations to support social inclusion of isolated older adults via online social networking are suggested.

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This chapter begins with an exploration of the digital divide in the Australian context. This discussion is followed by an examination of online education, professional development and the capacity of ICT to enhance the well-being of practitioners. The chapter then focuses on the use of ICT in human services and the rise of computer mediated self help and support groups. The potential for ICT to promote and extend political participation is also explored as well as the role of ICT in global development. Throughout, the potential for inclusion and exclusion is highlighted, using examples and critical analysis for exploring the inclusionary and exclusionary capacity of ICT.