Using information and communication technologies to consult with patients in Victorian primary care : the views of general practitioners

Information and communication technologies such as email, text messaging and video messaging are commonly used by the general population. However, international research has shown that they are not used routinely by GPs to communicate or consult with patients. Investigating Victorian GPs’ perceptions of doing so is timely given Australia’s new National Broadband Network, which may facilitate web-based modes of doctor-patient interaction. This study therefore aimed to explore Victorian GPs’ experiences of, and attitudes toward, using information and communication technologies to consult with patients. Qualitative telephone interviews were carried out with a maximum variation sample of 36 GPs from across Victoria. GPs reported a range of perspectives on using new consultation technologies within their practice. Common concerns included medico-legal and remuneration issues and perceived patient information technology literacy. Policy makers should incorporate GPs’ perspectives into primary care service delivery planning to promote the effective use of information and communication technologies in improving accessibility and quality of general practice care.

Psycho-social, ethical and legal arguments for and against the retrospective release of information about donors to donor-conceived individuals in Australia

In the February 2011 report on its inquiry into the past and present practices of donor conception in Australia, the Australian Senate Legal and Constitutional Affairs References Committee called for the introduction of legislation to regulate donor conception in all jurisdictions that do not have it in place "as a matter of priority". It further called for the establishment, "as a matter of priority", of a national register of donors to enable donor-conceived individuals to access identifying information about their donor. The Senate Committee left open the question as to whether the legislation and central register should have retrospective effect. This article focuses upon that question. It shows that arguments concerning the privacy, confidentiality and anonymity of some donors who may wish to remain anonymous are outweighed by the manifest injustice faced by donor-conceived individuals who are denied access to such information, as well as their families and donors who wish to exchange this information.

Learning from arid planning and design history and practice : from Woomera to creating the new Roxby Downs communities

The principles and knowledge about arid planning and design have much applicability to contemporary Australian planning discourses because of climate change evidence and policy shifts that sketch a hotter and more unreliable future climate with an emphasis upon a semi-arid environment for Australia. Despite this merit and intent, we appear to have learnt little from the past and are failing to draw upon the pioneering planning and design knowledge that underpinned community development and scaffolding in numerous Australian arid and semi-arid communities, and to bring this knowledge into our future planning processes and strategies.

This paper considers the essential attributes and variables of three Australian arid planning and design, drawing upon historical practice and research that have been explored in the planning of semi-arid and arid places including Port Pirie, Whyalla, Monarto, Broken Hill, Port Augusta, Leigh Creek, Andamooka, Olympic Dam Village and Roxby Downs. It specifically reviews Woomera Village (1940s) Shay Gap (1970s) and the proposed extensions to Roxby Downs (2010s) as models of how to better plan and design communities in arid environments. Instrumental in these innovations is the use of landscape-responsive urban design strategies, water harvesting and irregular rainfall capture, arid horticulture, building design, colour and materiality, orientation and shading strategies, and social community construction under difficult isolationist circumstances. The paper points to key strategies that need to be incorporated in future climate change responsive community developments and policy making.

Intractable or indomitable? How indigenous policy actors issues alive and contested

This is a report on the Australian news media and indigenous policymaking 1988-2008 ARC Discovery Project.

Planning research and educational partnerships with Indigenous communities : practice, realities and lessons

Increasingly planning practice and research are having to engage with Indigenous communities in Australia to empower and position their knowledge in planning strategies and arguments. But also to act as articulators of their cultural knowledge, landscape aspirations and responsibilities and the need to ensure that they are directly consulted in projects that impact upon their ‘country’ generally and specifically. This need has changed rapidly over the last 25 years because of land title claim legal precedents, state and Commonwealth legislative changes, and policy shifts to address reconciliation and the consequences of the fore-going precedents and enactments. While planning instruments and their policies have shifted, as well as research grant expectations and obligations, many of these Western protocols do not recognise and sympathetically deal with the cultural and practical realities of Indigenous community management dynamics, consultation practices and procedures, and cultural events much of which are placing considerable strain upon communities who do not have the human and financial resources to manage, respond, co-operate and inform in the same manner expected of non-Indigenous communities in Australia. This paper reviews several planning formal research, contract research and educational engagements and case studies between the authors and various Indigenous communities, and highlights key issues, myths and flaws in the way Western planning and research expectations are imposed upon Indigenous communities that often thwart the quality and uncertainty of planning outcomes for which the clients, research agencies, and government entities were seeking to create.

Working at the nexus between public health policy, practice and research : dynamics of knowledge sharing in the Netherlands

Background
Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.
This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing.
Method
An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories.
Results
Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives.
Conclusion
We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks.

Market failure, policy failure and other distortions in chronic disease markets

Background: The increasing prevalence of chronic disease represents a significant burden on most health systems. This paper explores the market failures and policy failures that exist in the management of chronic diseases.
Discussion: There are many sources of market failure in health care that undermine the efficiency of chronic disease management. These include incomplete information as well as information asymmetry between providers and consumers, the effect of externalities on consumer behaviour, and the divergence between social and private time preference rates. This has seen government and policy interventions to address both market failures and distributional issues resulting from the inability of private markets to reach an efficient and equitable distribution of resources. However, these have introduced a series of policy failures such as distorted re-imbursement arrangements across modalities and delivery settings.
Summary: The paper concludes that market failure resulting from a preference of individuals for 'immediate gratification' in the form of health care and disease management, rather than preventative services, where the benefits are delayed, has a major impact on achieving an efficient allocation of resources in markets for the management of chronic diseases. This distortion is compounded by government health policy that tends to favour medical and pharmaceutical interventions further contributing to distortions in the allocation of resources and inefficiencies in the management of chronic disease.

Monitoring policy and actions on food environments: rationale and outline of the INFORMAS policy engagement and communication strategies

 The International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS) proposes to collect performance indicators on food policies, actions and environments related to obesity and non-communicable diseases. This paper reviews existing communications strategies used for performance indicators and proposes the approach to be taken for INFORMAS. Twenty-seven scoring and rating tools were identified in various fields of public health including alcohol, tobacco, physical activity, infant feeding and food environments. These were compared based on the types of indicators used and how they were quantified, scoring methods, presentation and the communication and reporting strategies used. There are several implications of these analyses for INFORMAS: the ratings/benchmarking approach is very commonly used, presumably because it is an effective way to communicate progress and stimulate action, although this has not been formally evaluated; the tools used must be trustworthy, pragmatic and policy-relevant; multiple channels of communication will be needed; communications need to be tailored and targeted to decision-makers; data and methods should be freely accessible. The proposed communications strategy for INFORMAS has been built around these lessons to ensure that INFORMAS's outputs have the greatest chance of being used to improve food environments.

Patterns and correlates of self-reported racial discrimination among Australian Aboriginal and Torres Strait Islander adults, 2008–09: analysis of national survey data

Background
There is now considerable evidence that racism is a pernicious and enduring social problem with a wide range of detrimental outcomes for individuals, communities and societies. Although indigenous people worldwide are subjected to high levels of racism, there is a paucity of population-based, quantitative data about the factors associated with their reporting of racial discrimination, about the settings in which such discrimination takes place, and about the frequency with which it is experienced. Such information is essential in efforts to reduce both exposure to racism among indigenous people and the harms associated with such exposure.

Methods
Weighted data on self-reported racial discrimination from over 7,000 Indigenous Australian adults participating in the 2008–09 National Aboriginal and Torres Strait Islander Survey, a nationally representative survey conducted by the Australian Bureau of Statistics, were analysed by socioeconomic, demographic and cultural factors.

Results
More than one in four respondents (27%) reported experiencing racial discrimination in the past year. Racial discrimination was most commonly reported in public (41% of those reporting any racial discrimination), legal (40%) and work (30%) settings. Among those reporting any racial discrimination, about 40% experienced this discrimination most or all of the time (as opposed to a little or some of the time) in at least one setting. Reporting of racial discrimination peaked in the 35–44 year age group and then declined. Higher reporting of racial discrimination was associated with removal from family, low trust, unemployment, having a university degree, and indicators of cultural identity and participation. Lower reporting of racial discrimination was associated with home ownership, remote residence and having relatively few Indigenous friends.

Conclusions
These data indicate that racial discrimination is commonly experienced across a wide variety of settings, with public, legal and work settings identified as particularly salient. The observed relationships, while not necessarily causal, help to build a detailed picture of self-reported racial discrimination experienced by Indigenous people in contemporary Australia, providing important evidence to inform anti-racism policy.

Surveillance, Governance and Professional Sport

The surveillance capacities of professional sports clubs and Leagues are directly related to their modes of governance. This paper identifies how private sports clubs enact surveillance through processes of inclusion and exclusion. Using three examples to demonstrate these processes, we argue that the surveillance mechanisms associated with sports governance at times replicate, at other times contradict, and at other times influence those associated with broader law enforcement and security developments. These examples also suggest potential increases in surveillance activities that emerge in club governance often flow from external concerns regarding allegations of crime, national security breaches and corruption. These context-specific case studies (Flyvbjerg 2001) demonstrate how surveillance and identity authentication are closely tied to the complex, multi-tiered governance structures and practices in three distinct sports. We then explore how these patterns can be interpreted as either connected to or distinct from equivalent developments involving the surveillance surge (Murakami Wood 2009) and concepts of inclusion and exclusion under the criminal law. We conclude by discussing how both internal and external regulatory forces can shape interrelated facets of surveillance, governance and exclusion in elite sports.

The treatment of sex offenders : evidence, ethics, and human rights

Public policy is necessarily a political process with the law and order issue high on the political agenda. Consequently, working with sex offenders is fraught with legal and ethical minefields, including the mandate that community protection automatically outweighs offender rights. In addressing community protection, contemporary sex offender treatment is based on management rather than rehabilitation. We argue that treatment-as-management violates offender rights because it is ineffective and unethical. The suggested alternative is to deliver treatment-as-rehabilitation underpinned by international human rights law and universal professional ethics. An effective and ethical community–offender balance is more likely when sex offenders are treated with respect and dignity that, as human beings, they have a right to claim.

The inter-section of political history and health policy in Asia - the historical foundations for health policy analysis

One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own historical pathways.

Working with policy and regulatory factors to implement universal design in the built environment: the Australian experience

Built environments that are usable by all provide opportunities for engagement in meaningful occupations. However, enabling them in day to day design processes and practice is problematic for relevant professions. The purpose of this phenomenological study was to gain greater understanding of the policy and regulatory influences that promote or hinder the uptake of universal design in built environments, to inform better future design. Focus groups or telephone interviews were undertaken with 28 key building industry and disability stakeholders in Australia. Four themes were identified: the difficulties of definition; the push or pull of regulations and policy; the role of formal standards; and, shifting the focus of design thinking. The findings highlight the complexity of working within policy and regulatory contexts when implementing universal design. Occupational therapists working with colleagues from other professions must be aware of these influences, and develop the skills to work with them for successful practice.

Leaning too far? PISA, policy and Australia's ‘top five’ ambitions

 Australia has declared its ambition to be within the ‘top five’ in the Programme for International Student Assessment (PISA) by 2025. So serious is it about this ambition, that the Australian Government has incorporated it into the Australian Education Act, 2013. Given this focus on PISA results and rankings, we go beyond average scores to take a close look at Australia’s performance in PISA, examining rankings by different geographical units, by item content and by test completion. Based on this analysis and using data from interviews with measurement and policy experts, we show how uninformative and even misleading the ‘average performance scores’, on which the rankings are based, can be. We explore how a more nuanced understanding would point to quite different policy actions. After considering the PISA data and Australia’s ‘top five’ ambition closely, we argue that neither the rankings nor such ambitions should be given much credence.

Migration and refugee law: principles and practice in Australia

Migration and refugee law and policy is fundamentally concerned with the choices that we as a nation make regarding the people that we allow into our community and to share our resources. Migration and Refugee Law: Principles and Practice in Australia 2nd Edition provides an overview of the legal principles governing the entry of people into Australia. The 2nd edition encompasses legislative amendments and significant judicial decisions to 2007. As well as dealing with migration and refugee law today, the book analyses the policy and moral considerations underpinning this area of law. This is especially so in relation to refugee law, which is one of the most divisive social issues of our time. The book suggests proposals for change and how this area of law can be made more coherent and principled. This book is written for all people who have an interest in migration and refugee law.