Using a public key registry for improved trust and scalability in national E-health systems

An increasing number of countries are faced with an aging population increasingly needing healthcare services. For any e-health information system, the need for increased trust by such clients with potentially little knowledge of any security scheme involved is paramount. In addition notable scalability of any system has become a critical aspect of system design, development and ongoing management. Meanwhile cryptographic systems provide the security provisions needed for confidentiality, authentication, integrity and non-repudiation. Cryptographic key management, however, must be secure, yet efficient and effective in developing an attitude of trust in system users. Digital certificate-based Public Key Infrastructure has long been the technology of choice or availability for information security/assurance; however, there appears to be a notable lack of successful implementations and deployments globally. Moreover, recent issues with associated Certificate Authority security have damaged trust in these schemes. This paper proposes the adoption of a centralised public key registry structure, a non-certificate based scheme, for large scale e-health information systems. The proposed structure removes complex certificate management, revocation and a complex certificate validation structure while maintaining overall system security. Moreover, the registry concept may be easier for both healthcare professionals and patients to understand and trust.

IT governance stability in a political changing environment : exploring potential impacts in the public sector

Public sector organisations (PSOs) operate in information-intensive environments often within operational contexts where efficiency is a goal. What's more, the rapid adoption of IT is expected to facilitate good governance within public sector organisations but it often clashes with the bureaucratic culture of these organisations. Accordingly, models such as IT Governance (ITG) and government reform -in particular the new public management (NPM)- were introduced in PSOs in an effort to address the inefficiencies of bureaucracy and under performance. This work explores the potential effect of change in political direction and policy on the stability of IT governance in Australian public sector organisations. The aim of this paper is to examine implications of a change of government and the resulting political environment on the effectiveness of the audit function of ITG. The empirical data discussed here indicate that a number of aspects of audit functionality were negatively affected by change in political direction and resultant policy changes. The results indicate a perceived decline in capacity and capability which in turn disrupts the stability of IT governance systems in public sector organisations.

Factors for IT-enabled public sector process improvements in developing economies

IT resources are indispensable in the management of Public Sector Organizations (PSOs) around the world. We investigate the factors that could leverage the IT resources in PSOs in developing economies. While research on ways to leverage IT resources in private sector organizations of developed countries is substantial, our understanding on ways to leverage the IT resources in the public sector in developing countries is limited. The current study aspires to address this gap in the literature by seeking to determine the key factors required to create process value from public sector IT investments in developing countries. We draw on the resource-centric theories to imply the nature of factors that could leverage the IT resources in the public sector. Employing an interpretive design, we identified three factors necessary for IT process value generation in the public sector. We discuss these factors and state their implications to theory and practice.

The Australian mining industry and the ideal mining woman : mobilizing a public business case for gender equality

Despite ongoing ‘boom’ conditions in the Australian mining industry, women remain substantially and unevenly under-represented in the sector, as is the case in other resource-dependent countries. Building on the literature critiquing business-case rationales and strategies as a means to achieve women’s equality in the workplace, we examine the business case for employing more women as advanced by the Australian mining industry. Specifically, we apply a discourse analysis to seven substantial, publically-available documents produced by the industry’s national and state peak organizations between 2005 and 2013. Our study makes two contributions. First, we map the features of the business case at the sectoral rather than firm or workplace level and examine its public mobilization. Second, we identify the construction and deployment of a normative identity – ‘the ideal mining woman’ – as a key outcome of this business-case discourse. Crucially, women are therein positioned as individually responsible for gender equality in the workplace.

Design-build contractor selection for public sustainable buildings

Design-build (DB) is regarded as an effective means of delivering high performance green buildings, and the selection of DB contractors is of critical importance. The objective of this study is to evaluate the selection of design-builders for public buildings seeking Leadership in Energy and Environmental Design (LEED) certification and compare the selection practices involved with those of non-LEED-seeking DB projects through a robust content analysis of 74 DB request for proposals (RFPs) for public DB projects. The results of the content analysis reveal that the level of LEED certification is the dominant means of conveying the sustainability requirements in RFPs for contractor selection, with the majority of RFPs (60%) including sustainability requirements as part of the contractor evaluation package. With the exception of contractors' past performance, there is no statistically significant difference in the importance weightings of selection criteria between LEED-seeking and non-LEED-seeking buildings, and DB owners tend to place more emphasis on innovative technical solutions rather than the past performance of DB contractors. Additionally, the research findings also indicate that owners of LEED-seeking building projects tend to provide less design decisions in RFPs in order to solicit innovative design alternatives from potential DB contractors. This study provides DB owners with a number of practical implications for selecting appropriate design-builders for green DB projects.

How public owners communicate the sustainability requirements of green design-build projects

The design-build (DB) system is regarded as an effective means of delivering sustainable buildings. Specifying clear sustainability requirements to potential contractors is of great importance to project success. This research investigates the current state-of-the-practice for the definition of sustainability requirements within the public sectors of the U.S. construction market using a robust content analysis of 49 DB requests for proposals (RFPs). The results reveal that owners predominantly communicate their desired level of sustainability through the LEED certification system. The sustainability requirement has become an important dimension for the best-value evaluation of DB contractors with specific importance weightings of up to 25%. Additionally, owners of larger projects and who provide less design information in their RFPs generally allocate significantly higher importance weightings to sustainability requirements. The primary knowledge contribution of this study to the construction industry is the reveal of current trend in DB procurement for green projects. The findings also provide owners, architects, engineers, and constructors with an effective means of communicating sustainability objectives in solicitation documents.

Reflections on tomorrow’s menu : evidence for inpatient meal preferences at a large tertiary public hospital

There are limited studies that describe patient meal preferences in hospital; however this data is critical to develop menus that address satisfaction and nutrition whilst balancing resources. This quality study aimed to determine preferences for meals and snacks to inform a comprehensive menu revision in a large (929 bed) tertiary public hospital. The method was based on Vivanti et al. (2008) with data collected by two final year dietetic students. The first survey comprised 72 questions, achieved a response rate of 68% (n = 192), with the second more focused at 47 questions achieving a higher response rate of 93% (n = 212). Findings showed over half the patients reporting poor or less than normal appetite, 20% describing taste issues, over a third with a LOS >7 days, a third with a MST _ 2 and less than half eating only from the general menu. Soup then toast was most frequently reported as eaten at home when unwell, and whilst most reported not missing any foods when in hospital (25%), steak was most commonly missed. Hot breakfasts were desired by the majority (63%), with over half preferring toast (even if cold). In relation to snacks, nearly half (48%) wanted something more substantial than tea/coffee/biscuits, with sandwiches (54%) and soup (33%) being suggested. Sandwiches at the evening meal were not popular (6%). Difficulties with using cutlery and meal size selection were identified as issues. Findings from this study had high utility and supported a collaborative and evidenced based approach to a successful major menu change for the hospital.

Let them eat steak : food preferences of patients in a tertiary public hospital

Information on foods patients like and dislike is the essential basis for planning menus which are acceptable to patients and promote adequate consumption. The aim of this study was to obtain quantitative data on the food preferences of inpatients at a large metropolitan public hospital for use in menu planning. Methodology was based on a study by Williams et al (1988), and included additional questions about appetite and taste changes. The survey used a 9 point hedonic scale to rate foods listed in random order and was modified to incorporate more contemporary foods than those used in the originalWilliams study. Surveys were conducted by final year University of Queensland dietetics students on Food Service Practicum at the Royal Brisbane and Women’s Hospital (929 beds) in 2012. The first survey (220 questions, n = 157) had a response rate of 61%. The second included more sandwich fillings and salads (231 questions, n = 219, response rate 67%). Total number surveyed was 376. Results showed the most preferred foods were roast potato, grilled steak, ice cream, fresh strawberries, roast lamb, roast beef, grapes and banana. The least preferred foods were grapefruit, soybeans, lentils, sardines, prune juice and grapefruit juice. Patients who reported taste changes (10%) had similar food preferences to those who didn’t report taste changes. Patients who reported poor/very poor appetite (10%) generally scored foods lower than those who reported OK (22%), good/very good appetite (65%). The results of this study informed planning for a new patient menu at the RBWH in December 2012.

The global public health issue of pharmaceutical waste : what role for pharmacists?

Purpose Pharmaceuticals have played an important role in improving the quality of life of the human population in modern times. However, it must also be acknowledged that both the production and use of pharmaceuticals have a significant, negative impact on the environment and consequently, a negative impact on the health of humans and wildlife. This negative impact is due to the embedded carbon in pharmaceuticals' manufacture and distribution and the waste generated in their manufacture, consumption and disposal. Pharmaceutical waste is comprised of contaminated waste (unwanted pharmaceuticals and their original containers) and non-contaminated waste (non-hazardous packaging waste). The paper aims to discuss these issues. Design/methodology/approach The article is a literature review. Findings The article identified a gap in the literature around pharmacist attitudes and behaviour toward the environmentally responsible handling of pharmaceutical waste. Originality/value Pharmacists, with their professional commitment to the quality use of medicines and their active participation in the medicines management pathway, already play an important role in the more sustainable use of pharmaceuticals. Even so, they have the potential to play an even greater role with the environmentally responsible disposal of pharmaceutical waste (including packaging waste) and the education of other health professionals and the general public on this topic.

Conflicting notions of risk : the chasm of conflict between institutions and the public

The trust and credibility gap between institutional regulators and the public is based on fundamental social and cultural differences related to power and authority. It is also associated with the 'distance' of a bureaucracies from those whom they serve. The nature of public concern about risk may be investigated by considering specific cognitive decision making 'rules' such as 'familiarity' of a hazard or 'voluntariness' of exposure. A more complete appreciation of the 'how' and 'why' of public response to danger from industrial hazards can be gained by appreciating these 'rules' within the broader context of mis-communication between 'elite' regulators and a highly diverse public. If the results of risk assessments are expressed in technical terms alone, it is unlikely that any real communication will occur. Further, if issues related to the 'remote' nature of much institutional decision making are not addressed, closure of the 'gap' may be difficult to bring about.

Emergency powers and pandemics : federalism and the management of public health emergencies in Australia

Under the International Health Regulations 2005 Australia is obliged to develop a domestic framework designed to equip it to respond to public health emergencies. The legislative arrangements for the declaration of a public health emergency in Australia are complex, vary across state jurisdictions and intersect with other emergency powers. The task of harmonising laws and other arrangements within a federal system poses both challenges and opportunities for flexibility and choice. This article argues that Australia's current multi-strand and multi-level response provides a coordinated framework which also accommodates desirable levels of flexibility and choice.

Legal rights during pandemics : federalism, rights and public health laws - a view from Australia

Pandemic influenza will cause significant social and economic disruption. Legal frameworks can play an important role in clarifying the rights and duties of individuals, communities and governments for times of crisis. In addressing legal frameworks, there is a need for jurisdictional clarity between different levels of government in responding to public health emergencies. Public health laws are also informed by our understandings of rights and responsibilities for individuals and communities, and the balancing of public health and public freedoms. Consideration of these issues is an essential part of planning for pandemic influenza.

When should private property rights give way to the public interest?

Since Queensland Wire Industries Pty Ltd v Broken Hill Pty Co Ltd (1989) 167 CLR 177 it has been recognised that corporations with substantial market power are subject to special responsibilities and restraints that corporations without market power are not. In NT Power Generation Pty Ltd v Power and Water Authority (2004) 219 CLR 90 McHugh A-CJ, Gummow, Callinan and Heydon JJ in their joint reasons stated (at [76]), that s 46 of the Competition and Consumer Act 2010 (Cth) (CCA) can operate not only to prevent firms with substantial market power from doing prohibited things, but also compel them positively to do things they do not want to do. Their Honours also stated (at [126]) that the proposition that a private property owner who declines to permit competitors to use the property is immune from s 46 is “intrinsically unsound”. However, the circumstances in which a firm with substantial power must accommodate competitors, and private property rights give way to the public interest are uncertain. The purpose of this Note is to consider recent developments in two areas of the CCA where the law requires private property rights to give way to the public interest. The first part of the Note considers two recent cases which clarify the circumstances in which s 46 of the CCA can be used to compel a firm with substantial market power to accommodate a competitor and allow the competitor to make use of private property rights in the public interest. Secondly, on 12 February 2014 the Minister for Small Business, the Hon Bruce Billson,released the Productivity Commission’s Final Report, on the National Access Regime in Pt IIIA of the CCA (National Access Regime, Inquiry Report No 66, Canberra). Pt IIIA provides for the processes by which third parties may obtain access to infrastructure owned by others in the public interest. The Report recommends that Pt IIIA be retained but makes a number of suggestions for its reform, some of which will be briefly considered.