People, places and policies – trying to account for health inequalities in impoverished neighbourhoods

Objective : We consider associations between individual, household and area-level characteristics and self-reported health.
Method : Data is taken from baseline surveys undertaken in 13 socio-economically disadvantaged neighbourhoods in Victoria (n=3,944). The neighbourhoods are sites undergoing Neighbourhood Renewal (NR), a State government initiative redressing place-based disadvantage.
Analysis :This focused on the relationship between area and compositional factors and self-reported health. Area was coded into three categories; LGA, NR residents living in public housing (NRPU) and NR residents who lived in private housing (NRPR). Compositional factors included age, gender, marital status, identifying as a person with a disability, level of education, unemployment and receipt of pensions/benefits.
Results : There was a gradient in socio-economic disadvantage on all measures. People living in NR public housing were more disadvantaged than people living in NR private housing who, in turn, were more disadvantaged than people in the same LGA. NR public housing residents reported the worst health status and LGA residents reported the best.
Conclusions : Associations between compositional characteristics of disability, educational achievement and unemployment income and poorer self-reported health were shown. They suggested that area characteristics, with housing policies, may be contributing to differences in self-reported health at the neighbourhood level.
Implications : The clustering of socio-economic disadvantage and health outcomes requires the integration of health and social support interventions that address the circumstances of people and places.

The role and contribution of private land in Victoria to biodiversity conservation and the protected area system

The distribution and attributes of properties involved in three major programs for biodiversity protection on private land in Victoria, Australia, was investigated to determine their role in relation to the reserve system. Overlaying of dowsets in a geographic information system, with particular emphasis on property distribution in relation to bioregional and population centres, was undertaken. Land for Wildlife agreements had greater numbers of properties and total area protected in all bioregions throughout the State, yet average protected area sizes were lower than those of conservation covenants and Trust for Nature reserves. A combination of large bioregional area and human population size tended to attract more private conservation properties and, to a lesser extent, the total area they protected. The potential contribution that such properties made to biodiversity conservation varied between bioregions. Inclusion of properties within a national reserve framework is proposed to improve the coordination and effectiveness of conservation measures.

Performance and narrative, bodies and movement in the construction of places and objects, spaces and knowledges: The case of the Maltese megaliths

The article explores the ways knowledge and space are co-produced performatively through bodily movement in an examination of the Maltese megaliths the first complex stone structures in the world. It is argued that knowledge is best seen as spatialized narratives of human actions and objects as materialized forms of those spatial narratives. Rewriting our social and historical narratives so that the performativity of place, space and knowledge is restored opens new possibilities for rethinking the social and material order.

Recruiting in public places : A strategy to increase diversity in qualitative research samples

For some research projects, recruiting in public places is an invaluable addition to sampling strategies. It complements the more traditional recruitment strategies by providing researchers with' opportunities to include people in the research who would otherwise be excluded. One of the limitations of selective and snowball sampling is that participants often come from the same social group. Participants from these social groups often share similar experiences and ways of thinking about those experiences. The aim of recruiting in public places is to move beyond this 'in group' to ensure a wider perspective. This paper illustrates how recruiting in public places can provide greater sample diversity for theoretical strength. The paper begins with a brief overview of recruiting in public places. It then describes the theoretical considerations associated with this recruiting strategy. The paper demonstrates how recruiting in public places facilitates grounded theory by providing comparisons that are informed by diverse experiences. Using examples and a case study, we illustrate how recruiting in public places can complement selective, snowball and theoretical sampling to ensure a more comprehensive sample.

The meaning of professional excellence for private practitioners in occupational therapy

OT AUSTRALIA's Accredited Occupational Therapist Program is promoted using the message 'Assuring professional excellence'. It is widely assumed that professional excellence is understood. Yet, this concept encompasses complex themes, including competence and clinical reasoning. In this paper, the meaning of professional excellence is examined by investigating the perspectives of private practitioners. Private practitioners were chosen as they represent the diversity of the occupational therapy field, and may pre-empt trends within broader practice. Sixteen key informants were interviewed to obtain their perspectives on professional excellence. Common themes that arose from the findings include the significance of experience in practice, and the importance of understanding one's limitations in knowledge and expertise. Findings are discussed in relation to OT AUSTRALIA's aim to assure standards of practice.

The effect of private school competition on public school performance in Georgia

This article presents estimates of the effect of private school competition on public school performance. Using data on school districts in Georgia, the authors estimate models relating tenth- and third-grade test scores for either reading or mathematics to the level of private school competition. Test scores are not measurably or significantly higher in areas with greater private school competition, a result robust through multiple estimations using three measures of private school competition and a variety of control variables. The authors address the possible endogeneity between test scores and private school competition using instrumental variables estimators, with percentage of the population that is Catholic, county population in 1980, lagged competition, and various other measures as alternative instruments.

Mismanagement of delerium places patients at risk

Objective: This paper discusses the problem of delirium and the challenges of accurately assessing, preventing and managing patients with delirium in an acute care setting.

Primary Argument: Acute confusion, also known as delirium, is misdiagnosed and under-treated in up to 94% of older patients in hospitals. With the ageing population, this problem will increase dramatically in the Australian setting. Managing patients with delirium is challenging not only for the management of their basic nursing care needs but also because they are prone to adverse events such as falls and medication problems. In order to address this issue it is vital that health care professionals routinely assess patients for signs of delirium. The current 'gold standard' for assessing delirium is the use of the Confusion Assessment Method (CAM) which has been developed based on the diagnostic criteria set by the Diagnostic and Statistical Manual of Mental Disorders DSM-IV and can be used by non-psychiatrists. Further, increased attention should be given to the prevention and management of delirium and the use of orientation and validation therapy.

Conclusion: Research indicates that early identification and intervention can help to limit any negative effects or adverse events. Increasing knowledge and awareness of early detection and efficient management of delirium is the first step toward prevention.

People, places...and other people? Integrating understanding of intrapersonal, social and environmental determinants of physical activity

“People or places: what should be the target?” was the provocative title of a keynote session at the fifth Australian National Physical Activity Conference held in Melbourne in 2005. This paper will argue that in fact there need not be major conflict between these views, and that couching recent debate about physical activity promotion as a polarised choice between these presents a false dichotomy. To illustrate this, the paper will consider several problems with singular approaches to understanding and promoting physical activity, and will then describe emerging empirical evidence on the nexus between people and places. To balance an increasing emphasis in the scientific literature on physical environmental determinants of physical activity, the role of intrapersonal and social factors will also be revisited. It is concluded that growing evidence supporting the multiple domains of influence on physical activity justifies calls for multi-disciplinary and multi-sectoral partnerships and approaches to the promotion of active lifestyles.

Private protected areas? Assessing the suitability for incorporating conservation agreements over private land into the National Reserve System : a case study of Victoria

All Australian governments are committed to the establishment of a  comprehensive, adequate and representative system of conservation  reserves. Many of the most threatened species and communities throughout Australia occur mainly or wholly on private land. A range of mechanisms has been developed to achieve conservation on private land. This article  assesses the legal security, permanence and management intent of such mechanisms in Victoria, in relation to protected area criteria. The  implications of this analysis for the Australian National Reserve System and landowners with these mechanisms on their properties are discussed.

Professional competence for private practitioners in occupational therapy

The aim of the present study was to investigate the meaning of professional competence for occupational therapy private practitioners and their experience of the barriers to professional competence. Semi-structured interviews with 16 key informants from private practice in Victoria elicited diverse opinions and experiences. However, the difficulty of assessing competence, and the lack of standards that identify competent practice for occupational therapy were major themes in the findings. The role of theory in competent practice was evident in discussion but it was not clearly articulated by many participants. Experiences of professional socialisation varied yet participants perceived input from peers as contributing to assuring competence. Major barriers to professional competence were identified as professional isolation, time and finances. The present study highlights the complexity of current attempts to assess professional competence for practising occupational therapists including the implementation of an accreditation program by The Australian Association of Occupational Therapists Inc. (OT AUSTRALIA), the peak body representing occupational therapists.