Folate fortification : a case study of public health policy-making

This thesis investigates the use of scientific evidence in the process of making public health policy. A case study located within a food regulation setting is used. The aim is to test theory against this case study. The outcome is a theoretical understanding of the use of scientific evidence in the policy-making process in a food regulation setting. Food regulation can influence food composition and food labelling and thereby affect the population's dietary intake. Frequently there are contested values, beliefs, ideologies and interests among stakeholders regarding the use of food regulation as a policy instrument to effect public health outcomes. The protection of public health and safety, taking into account evidence based practice, is generally employed by food regulators as the priority objective during the policy-making process to adjudicate among the competing expectations of stakeholders. However, this policy objective has not been clearly defined and is vulnerable to interpretation and application. The process by which folate fortification policy was made in Australia, in response to epidemiological evidence of a relationship between folate intake during the periconceptional period and reduced risk of neural tube defects, was analysed as a case study of the policy-making process. The folate fortification policy created a precedent for both food fortification and subsequently health claims policy in Australia. A social constructivist method was used to analyse the case study. The method involved deconstructing the food regulatory system into three levels; decision-making process; procedural; and political environment. Data aligned with each level of analysis was collected from 22 key informant interviews, documentary sources, field notes and surveys of both a random sample of the Australian population's knowledge of folate and use of folic acid-containing supplements (n = 5422), and the implementation of folate fortified food products into stores (n = 60). The insights that emerged from each of the three levels of analysis were assessed iteratively to identify a pattern of interrelationships associated with the policy-making process within the food regulatory system. The identified pattern was interpreted against existing theory to gain a theoretical understanding of the public health policy-making process in this political setting. The central argument of this thesis extends Sabatier and Jenkins-Smith's Advocacy Coalition Framework theory to a food regulation setting. The argument is that within the contemporary political climates of neoliberalism and globalisation, a coalition between corporate interests and the values of scientists with a positivist-reductionist approach to public health research is privileged so as to invoke certain scientific evidence to, in turn, legitimise food regulation policy decisions. The theory will help to inform policy-makers about how and why the public health policy objective in a food regulation setting is interpreted and applied. This will contribute to improving policy practice intended to effect public health outcomes. It is concluded that irrespective of the quantity and quality of the scientific evidence that is being made available, scientific evidence cannot be assumed to speak for itself Policy-making is an inherently political and value-laden process and the potential for politically motivated interpretation and application of otherwise value-neutral scientific evidence can undermine the investment in its generation. From this perspective, evidence based practice, far from liberating policy-making from political influence, can itself become part of the problem rather than the solution. Nevertheless, rational evidence based practice is an ideal to strive for and a series of recommendations is proposed to help make the use of evidence in current food regulation policy processes more transparent and democratic.

A-REIT bidder returns : an evaluation of public and private targets and method of payment

This study examines the wealth effects of fifty-six Australian Real Estate Investment Trusts (A-REITS) acquirers around the announcement date of a merger and acquisition over the period of 1996 to 2010. This study extends Ratcliffe et al (2009) by examining mergers and acquisitions of private entity targets as well as public targets and confirms recent US REIT work in this field. Utilising event study methodology we find that bidding A-REITs earn positive and significant cumulative abnormal returns (CARs) of +0.966% around the three-day announcement period [-1, +1]. Analysis also indicates bidding firms earn higher CARs when the acquisition is financed by scrip and/or a combination of scrip and cash. Consistent with prior REIT research, event study results show that A-REIT acquirers earn higher excess returns when the target is private as compared to a public target, +2.834% and +0.457% respectively. Further investigation, employing regression analysis, shows book-to-market ratio has a negative impact on bidding firms CARs, suggesting that investors penalise high book-to-market A-REITs in an M&A due to their higher risk characteristics. We also find that both specialisation by property type and relative size of the bidder compared to the target has a positive and significant influence on bidder excess returns. Finally, our results show support for the method of payment findings in the event study, with method of payment returning a negative and significant impact on the bidder CARs.

Identifying attributes contributing to environmental sustainability of public-private partnership infrastructure projects

Due to increasing demands for new infrastructure and an aim to reduce initial public investment, Australian government agencies are increasingly using public-private partnerships (PPPs) as a form of delivery for infrastructure projects. Environmentally, there is growing pressure for the building industry in general to become more sustainable. Moreover, as the built environment continues to grow each year, the performance of buildings as a whole will need to continually improve purely for national energy consumption to remain stable. Based on a systematic and extensive review on relevant literature, this paper has identified the key attributes that will influence the environmental sustainability of infrastructure completed through a PPP. The key attributes are grouped into five groups defined by whom or what has the majority of control over the attribute. Meanwhile, the key attributes are explored and their influence on environmental sustainability justified. This paper was able to not only identify significant factors involved in creating environmental sustainability in infrastructure PPPs, but also trends of the key attributes. It has been found that (1) the longevity of the contract in a PPP project allows greater innovation into environmental sustainability than traditional methods of procurement, (2) innovation is a requirement for the improving upon environmental performance in the built environment, (3) improvements to environmental sustainability relies upon a positive relationship between economic and environmental benefits, and (4) the key attributes for PPP projects are decided upon relatively early in the contract. Due to space limit, detailed discussion on each of the identified attributes is not provided in this paper. Nonetheless, further research direction is discussed.

Big change questions : can we create a form of public education that delivers high standards for all students in the emerging knowledge society?

Within many Anglophone nation states there is significant debate about
the future of public education and its ongoing capacity to provide quality
education. The new knowledge economy not only challenges the position
of educators as the primary producers, disseminators and authorizers of
what is valued knowledge, but also requires them to prepare students for
new ways of working with that knowledge. In the service economies of
post-industrial Western nations, 'knowledge work' is critical to national
productivity and international competitiveness. At the same time, the
globalization logic suggests that the nation state is under threat, and therefore its role as provider of universal services such as education is also threatened.

Reflexive modernity and the art of public communication

In 2000, Victoria’s largest regional council, the City of Greater Geelong, allocated $200,000 to fund a community art and place-making project in inner Geelong West. The Walk West project was conceptualised and lobbied by a community group for six years. The project addressed the impact of a large section of freeway installed in the seventies and its consequences for quality of life in the locality.

This article reports on an example of highly developed community relations. It examines public art and placemaking as public communication tools and their relationship to political and social activity in post-amalgamation Victoria. In particular it applies the theories of Ulrich Beck and the notion of reflexive modernity in risk society where citizens’ initiative groups will play an increasingly important role in reclaiming the biological and cultural heritage lost as a result of ‘progress’.

Reviewing public reason: a critique of rawls' political liberalism and the idea of public reason

This article provides a critical review of Rawls' effort in Political Liberalism to construct apolitical theory of justice compatible with the fact of reasonable pluralism. Particular attention is given to the 'idea of public reason' and political liberalism's liberal neutrality. It is argued that because of its liberal neutrality, political liberalism would preclude people from endorsing at least some reasonable comprehensive views and, therefore, as a theory it lacks the necessary stability required to be as successful as Rawls claims.

Finding voices: authentic learning online in the field of public communication and citizenship

A creative re-acculturation of teachers and students is occurring in virtual classrooms as traditional learning resources, pedagogy, and technology intersect in unexpected ways. This paper reports on a case of authentic, experiential, and constructivist learning developed for tertiary public relations  students. A subject titled ‘Public Communication and Citizenship’ (PCC) at  Deakin University in Australia asked students to examine the problematic and contentious areas of self interest, persuasion, power, and ethics in  contemporary contexts of mass media and globalisation. Feedback from  those students suggests that, in this case, online teaching strategies  successfully integrated with the total learning environment to achieve  higher-order learning. PCC is one example of PR pedagogy combining  theory and technology to move beyond ‘skilling for jobs’.

Removal of directors of public companies takes centre stage in Australia : an exploration of the corporate law and governance issues

Increasing attention is being given to the legal and governance issues relating to the removal of directors in Australian public companies. This has been due mainly to the difficulties experienced by the board of National Australia Bank in attempting to remove one of its fellow directors, and the subsequent development of public companies entering into so-called 'prenuptial agreements' with new directors, requiring that the director 'resign' if the board pass a vote of no-confidence in the director. In this article, the author revisits the area of director removal in Australian public companies for two reasons. The first reason, which covers the majority of the article, is to engage in a detailed analysis of whether the pre-nuptial agreements which some public companies have indicated that they support using to remove directors, are in fact enforceable under Australia's Corporations Act The second reason is to outline a law reform proposal to enable public companies to remove directors without requiring the vote of shareholders at a general meeting. The proposal involves providing Australia' corporate  regulator, the Australian Securities and Investments Commission (ASIC) with the power to grant relief from the statutory removal provisions to public companies, but in a way which balances the competing objectives of commercial efficiency and shareholder participation and, very importantly, encourages good corporate governance practices by companies in relation to the performance assessment  of directors.

It is in the interests of both shareholders and directors to agree on a set of ground rules for the effective supervision of companies that reconciles the rights of the owners to overall control with the much tougher demands on modern directors

It's in your hands : the value of handsearching in conducting systematic reviews of public health interventions

Background While there is an emerging evidence base in public health, the evidence can often be difficult to find. Indexing of journals in MEDLINE has assisted those conducting systematic reviews to more easily identify published studies. However, information technology and the processes associated with indexing are not infallible. Studies may not be correctly marked by study design which may mean they are missed in the electronic searching process. Handsearching for evidence of intervention effectiveness has therefore become a recognized tool in the systematic review process.

Methods Resources to guide handsearching activity currently are clinically focused, and may not be sensitive to the characteristics of public health studies where study terminology may differ. In response to this issue, the Cochrane Health Promotion and Public Health Field (the Field) developed and implemented a small study to recruit and support handsearchers from around the world to identify health promotion and public health trials and systematic reviews. A strategic framework was developed to recruit and support handsearchers to search six public health-related journals.

Results In total, 131 trials and 21 systematic reviews were identified. The greatest value of handsearching was found to be in supplement editions and abstract sections of journals

Conclusions The study focused exclusively on indexed journals with the intention that tools and methods developed could be used to explore the potential for handsearching in non-indexed journals and for unpublished studies. The findings from this study will continue to support handsearching efforts and in doing so contribute to high quality systematic reviews of public health interventions.

Is availability of public open space equitable across areas?

This study examined whether availability of public open spaces that can be used for recreation varies according to neighbourhood socio-economic disadvantage. Density and area of public open spaces were examined using a geographic information system and postal boundaries were used to define neighbourhoods. Neighbourhood socio-economic status (SES) was stratified into quintiles. Once neighbourhood population and geographic area were considered there were no differences in the number or total area of free-access, restricted access or sporting/recreation open spaces across quintiles of neighbourhood SES. Future research should examine whether the quality of public open spaces differ by neighbourhood SES.

Evaluating the effectiveness of public health interventions: the role and activities of the Cochrane Collaboration

Public health decision makers, funders, practitioners, and the public are increasingly interested in the evidence that underpins public health decision making. Decisions in public health cover a vast range of activities. With the ever increasing global volume of primary research, knowledge and changes in thinking and approaches, quality systematic reviews of all the available research that is relevant to a particular practice or policy decision are an efficient way to synthesise and utilise research efforts. The Cochrane Collaboration includes an organised entity that aims to increase the quality and quantity of public health systematic reviews, through a range of activities. This paper aims to provide a glossary of the terms and activities related to public health and the Cochrane Collaboration.