Managing health care in Australia : steps on the health care roundabout?

This paper explores some of the lessons of the coordinated care trials in Australia in the context of managed care in America and asks how do we best manage our finite health care dollars for the most equitable and effective outcomes for whole populations? The COAG trial in Australia tested a more structured process for managing the care of patients with chronic illness and postulated that currently fragmented health system funding could be pooled around individual patient need, and managed for improved economic outcomes and patient wellbeing. There is little doubt, following this initiative and much work in other countries, that as health care costs rise, for a range of reasons, improvements are needed in the management of our resources if we are to control rising health care costs. We also know that chronic illness, much of which is preventable and avoidable, is the major component in the rising health care cost equation and a factor likely to consume around 75% of our health dollars in the future. Much chronic illness can be prevented through social and population health strategies and we know that even if chronic illness can?t be prevented, it can be managed better through community-based chronic illness management programs. These programs rely on information, education, patient lifestyle and behaviour change, and on patients developing improved self-management skills. But, what is the best way to manage population health in Australia and ensure equity and fairness in the health care market as we evolve new approaches, especially to the management of chronic illness?

Tantalus and the tyranny of territory : pursuing the dream of parity in rural and metropolitan population health outcomes through primary health care programs

Many health professionals and rural health academics are motivated by the challenge of achieving equitable access to health care in rural communities with the implicit vision that fairer access to services might ultimately lead to more equitable health outcomes for people living in rural and remote settings. The purpose of this paper is to put the issue of rural and urban health outcome parity into perspective and assess recent progress towards achieving the ultimate goal of improving rural health status. I will also explore ways in which rural communities might increase their access to and use of primary health care revenue in the future to improve community health outcomes. While some improvements have been achieved across the rural health system in recent times, the fundamental problem of maintaining infrastructure to service community needs in rural areas remains as daunting as ever. Extensive evidence has now been assembled to show that rural people generally enjoy a much lower standard of health care, health outcomes and life expectancy than their urban cousins. The question underlying all of this evidence, however, is... must this always be so? Is it possible to redress the current inequities between rural and urban populations and could new primary health care initiatives, such as the Enhanced Primary Care (EPC) program, be vehicles for achieving more equitable health care arrangements and health outcomes for people living in rural communities?

The Centre of Clinical Research Excellence in Aboriginal Health : an operational rationale and some reflections on progress so far

The Centre of Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health was established in late 2003 through a major National Health and Medical Research Council (NHMRC) grant involving collaboration between the Aboriginal Health Council of South Australia (AHCSA), Flinders University, and Aboriginal Health Services. Our foundation research communities are the Aboriginal communities served by these Aboriginal Health Services in the Spencer Gulf / Eyre Peninsula region. In recent years a number of collaborative research programs involving chronic illness management, self-management and coordinated care have been implemented in these communities and this work is the basis of the initial CCRE activities. Key objectives of the CCRE are to improve the health status of Indigenous people through conducting relevant and meaningful Aboriginal controlled health research, providing formal training for Indigenous health researchers and developing innovative approaches to health care that can be readily translated and applied to support communities. The inclusion, empowerment and engagement of Indigenous people in the process of managing community health represent tangible strategies for achieving more equitable health outcomes for Aboriginal people. This paper outlines the CCRE operational rationale and presents early activities and outcomes across the three strategic areas of CCRE operations: research, education and training, and translation. Some critical reflections are offered on the progress and experience of the CCRE thus far. A common obstacle this CCRE has encountered is that the limited (especially staff) resources available to the Aboriginal Health Services with which we are collaborating make it difficult for them to engage with and progress the projects we are pursuing.

Animals and urban informality in sacred spaces: bull-calf trafficking in Simhachalam Temple, Vishakapatnam

Religion and Urbanism contributes to an expanded understanding of 'sustainable cities' in South Asia by demonstrating the multiple, and often conflicting ways in which religion enables or challenges socially equitable and ecologically sustainable urbanisation in the region. In particular, this collection focuses on two aspects that must inform the sustainable cities discourse in South Asia: the intersections of religion and urban heritage, and religion and various aspects of informality.

This book makes a much-needed contribution to the nexus between religion and urban planning for researchers, postgraduate students and policy makers in Sustainable Development, Development Studies, Urban Studies, Religious Studies, Asian Studies, Heritage Studies and Urban and Religious Geography.

Religion, urbanism and sustainable cities in South Asia

Religion and Urbanism contributes to an expanded understanding of 'sustainable cities' in South Asia by demonstrating the multiple, and often conflicting ways in which religion enables or challenges socially equitable and ecologically sustainable urbanisation in the region. In particular, this collection focuses on two aspects that must inform the sustainable cities discourse in South Asia: the intersections of religion and urban heritage, and religion and various aspects of informality.

This book makes a much-needed contribution to the nexus between religion and urban planning for researchers, postgraduate students and policy makers in Sustainable Development, Development Studies, Urban Studies, Religious Studies, Asian Studies, Heritage Studies and Urban and Religious Geography.

Religion and urban policy for South Asia: where next?

Religion and Urbanism contributes to an expanded understanding of 'sustainable cities' in South Asia by demonstrating the multiple, and often conflicting ways in which religion enables or challenges socially equitable and ecologically sustainable urbanisation in the region. In particular, this collection focuses on two aspects that must inform the sustainable cities discourse in South Asia: the intersections of religion and urban heritage, and religion and various aspects of informality.

This book makes a much-needed contribution to the nexus between religion and urban planning for researchers, postgraduate students and policy makers in Sustainable Development, Development Studies, Urban Studies, Religious Studies, Asian Studies, Heritage Studies and Urban and Religious Geography.

Gender issues in elementary mathematics teaching materials: a comparative study between China and Australia

International Association for the Evaluation of Educational Achievement (IEA) cross-national studies (FIMS, SIMS and TIMSS) show that gender differences in mathematical achievements and attitudes have decreased considerably over thirty years (Hanna, 2000), however, mathematics is still historically stereotyped as a male domain with crucial evidence supporting this belief (Forgasz, Leder, & Kloosterman, 2009). Previous research showed that gender differences in mathematics participation,performance and achievement existed widely in the majority of English speaking countries, specifically favouring boys (Forgasz, 1992; Hyde, Fennema, & Lamon, 1990; Tiedemann, 2000). Hyde, Lindberg, Linn, Ellis and Williams (2008) pointed out that the stereotype that females lack mathematical ability persists and is widely held by parents and teachers.Mathematics teaching materials play an important role in mathematics teaching and learning. The contents within mathematical teaching materials are rational, and deliver both explicit and implicit information. The explicit information refers to mathematics knowledge that students can learn from textbooks, while the latter one, also named as hidden curriculum, contains social and cultural messages. Hidden curriculum is a side effect of education. It has deep and long-term influences on students’ construction of math-gender stereotype that impact their future mathematicallearning (Zhang & Zhou, 2008). Therefore, this study will investigate Chinese andAustralian elementary mathematics teaching materials to explore the messages of gender equity and inequity delivered through hidden curriculum including names, images and problem-solving contexts. Based on the findings, practical implications concerning the promotion of equitable gender environments within elementary mathematics teaching materials from a cross-cultural perspective will be discussed.

Few geographic and socioeconomic variations exist in primary total shoulder arthroplasty: a multi-level study of Australian registry data

BACKGROUND:Associations between socioeconomic position (SEP) and the uptake of primary total shoulder arthroplasty (TSA) is not well understood in the Australian population, thus potentially limiting equitable allocation of healthcare resources. We used the Australian Orthopaedic Association National Joint Replacement Registry (AOA NJRR) to examine whether geographic or socioeconomic variations exist in TSA performed for a diagnosis of osteoarthritis 2007-11 for all Australians aged ≥40 years.

METHODS:Primary anatomical and reverse TSA data were extracted from the AOA NJRR which captures >99 % of all TSA nationally. Residential addresses were cross-referenced to Australian Bureau of Statistics 2011 Census data to identify SEP measured at the area-level (categorised into deciles), and geographic location defined as Australian State/Territory of residence. We used a Poisson distribution for the number of TSA over the study period, and modelled the effects of age, SEP and geographic location using multilevel modelling.

RESULTS:During 2007-11, we observed 6,123 TSA (62.2 % female). For both sexes, TSA showed a proportional increase with advancing age. TSA did not vary by SEP or geographic location, with the exception of greater TSA among men in New South Wales.

CONCLUSIONS:Using a national registry approach we provide the first reliable picture of TSA at a national level. The uptake of TSA was equitable across SEP; however, there was some variation between the States/Territories. With an aging population, it is imperative that monitoring of major surgical procedures continues, and be focused toward determining whether TSA uptake correlates with need across different social and area-based groups.

Can policy ameliorate socioeconomic inequities in obesity and obesity-related behaviours? A systematic review of the impact of universal policies on adults and children

This systematic review examined the impact of universal policies on socioeconomic inequities in obesity, dietary and physical activity behaviours among adults and children. PRISMA-Equity guidelines were followed. Database searches spanned from 2004 to August 2015. Eligible studies assessed the impact of universal policies on anthropometric, dietary or physical activity-related outcomes in adults or children according to socioeconomic position. Thirty-six studies were included. Policies were classified as agentic, agento-structural or structural, and their impact on inequities was rated as positive, neutral, negative or mixed according to the dominant associations observed. Most policies had neutral impacts on obesity-related inequities regardless of whether they were agentic (60% neutral), agento-structural (68% neutral) or structural (67% neutral). The proportion of positive impacts was similar across policy types (10% agentic, 18% agento-structural and 11% structural), with some differences for negative impacts (30% agentic, 14% agento-structural and 22% structural). The majority of associations remained neutral when stratified by participant population, implementation level and socioeconomic position measures and by anthropometric and behavioural outcomes. Fiscal measures had consistently neutral or positive impacts on inequities. Findings suggest an important role for policy in addressing obesity in an equitable manner and strengthen the case for implementing a broad complement of policies spanning the agency-structure continuum.

When the private becomes public: commodity activism, endorsement, and making meaning in a privatised world

The divide between the public realm and the private realm is a both a moveable and permeable boundary. One of the reasons for this fluidity as to what constitutes these two realms is driven by different political postures. From a neoliberal position, the private—be that private industry, the individual self, the engines of the economy—is better able to produce the Benthamite characterisation of happiness for the greatest number. In contrast, from a socialist to social democratic position, an expanded public disbursement of commonwealth is seen to produce a more equitable, just, and ultimately happy society. Somewhere between these two extremes is a regulated marketplace which more or less describes the organisation of most Western polities.This paper investigates a relatively new form of public activism that, in a sense, emerges from a cultural condition of the ascendancy of the privatisation of politics and culture. Commodity activism, as it is now called by researchers, begins with a politics of the marketplace and turns it into a normative position or posture related to the public sphere. This kind of politics has emerged from consumer movements that have a long history of turning the private into the domain of the public through boycotts, forms of usually negative publicity, and an active engagement of appropriating the key identity of “privatisation,” which is that of the consumer, and re-politicising it into something akin to a form of active citizen. The paper is a study of this changing of the private into the public and how this process relies on the concept of endorsement—particularly high-profile celebrity figures who have gained their power as individuals in this privatised space and now use that form of power for other purposes—in order to gain attention and circulation in this now privatised public sphere.

A Comparison Study of the English III/American Literature Success of African American High School Students and That of Students Whose Home Language is Haitian Creole

The purpose of the study was to compare the English III success of students whose home language is Haitian Creole (SWHLIHC) with that of the more visible African American high school students in the Miami Dade County Public Schools System, in an effort to offer insight that might assist educators in facilitating the educational success of SWHLIHC in American Literature class. The study was guided by two important theories on how students interact with and learn from literature. They are Reader Response Theory which advocates giving students the opportunity to become involved in the literature experience (Rosenblatt, 1995), and Critical Literacy, a theory developed by Paolo Freire and Henry Giroux, which espouses a critical approach to analysis of society that enables people to analyze social problems through lenses that would reveal social inequities and assist in transforming society into a more equitable entity. Data for the study: 10th grade reading FCAT scores, English III/American Literature grades, and Promotion to English IV records for the school year 2010-2011 were retrieved from the records division of the Miami Dade County Public Schools System. The study used a quantitative methods approach, the central feature of which was an ex post facto design with hypotheses (Newman, Newman, Brown, & McNeely, 2006). The ex post facto design with hypotheses was chosen because the researcher postulated hypotheses about the relationships that might exist between the performances of SWHLIHC and those of African American students on the three above mentioned variables. This type of design supported the researcher’s purpose of comparing these performances. One way analysis of variance (ANOVA), two way ANOVAs, and chi square tests were used to examine the two groups’ performances on the 10th grade reading FCAT, their English III grades, and their promotion to English IV. The study findings show that there was a significant difference in the performance of SWHLIHC and African American high school students on all three independent variables. SWHLIHC performed significantly higher on English III success and promotion to English IV. African American high school students performed significantly higher on the reading FCAT.

Understanding the Impact of the Property Tax Appeal Process on Assessment Uniformity: Procedures, Structures, and Outcomes

Property taxes serve as a vital revenue source for local governments. The revenues derived from the property tax function as the primary funding source for a variety of critical local public service systems. Property tax appeal systems serve as quasi-administrative-judicial mechanisms intended to assure the public that property tax assessments are correct, fair, and equitable. Despite these important functions, there is a paucity of empirical research related to property tax appeal systems. This study contributes to property tax literature by identifying who participates in the property tax appeal process and examining their motivations for participation. In addition, the study sought to determine whether patterns of use and success in appeal systems affected the distribution of the tax burden. Data were collected by means of a survey distributed to single-family property owners from two Florida counties. In addition, state and county documents were analyzed to determine appeal patterns and examine the impact on assessment uniformity, over a three-year period. The survey data provided contextual evidence that single-family property owners are not as troubled by property taxes as they are by the conduct of local government officials. The analyses of the decision to appeal indicated that more expensive properties and properties excluded from initial uniformity analyses were more likely to be appealed, while properties with homestead exemptions were less likely to be appealed. The value change analyses indicated that appeals are clustered in certain geographical areas; however, these areas do not always experience a greater percentage of the value changes. Interestingly, professional representation did not increase the probability of obtaining a reduction in value. Other relationships between the variables were discovered, but often with weak predictive ability. Findings from the assessment uniformity analyses were also interesting. The results indicated that the appeals mechanisms in both counties improved assessment uniformity. On average, appealed properties exhibited greater horizontal and vertical inequities, as compared to non-appealed properties, prior to the appeals process. After, the appeal process was completed; the indicators of horizontal and vertical equity were largely improved. However, there were some indications of regressivity in the final year of the study.

Strategic Diplomacies: Indigenous Governance, International Politics, and Natural Resources in Canada

International Relations theory would predict that central governments, with their considerable material resources, would be unlikely to face a challenge from a substate government. However, substate governments, and particularly Indigenous governments, are pushing back against central government control in both domestic and international spheres. Indigenous governments are leveraging their local mining sectors to realize their interests and express local identities—interests and identities that may not be congruent with those of the central government. Applying the case study of the resource extraction sector in Canada, this thesis asks: under what conditions are substate governments able to challenge the authority of central governments in the international arena? Canada’s reliance on the global extractive resource sector is a major driver of its international policy preferences, but the increased engagement of Indigenous governments in the sector challenges the control of the federal government. Focusing on the resource extraction sectors in British Columbia, Saskatchewan, and Ontario, this thesis argues that there is a mutually reinforcing relationship between Indigenous governments’ international engagement and their domestic autonomy; both challenge the parameters of state authority. Both force the state to respond to claims of control from multiple sites and to clarify convoluted policy environments. A confluence of factors—including increased Indigenous connections to the globalized economy, new Canadian regulatory frameworks, and recent Supreme Court of Canada cases regarding Indigenous lands—have all altered the space in which Indigenous governments in Canada participate in the resource extraction sector and produce overlapping or multilevel governance structures. This thesis demonstrates that Indigenous international engagement entrenches the authority and political legitimacy manifest in Indigenous governments’ insistence on equitable and horizontal negotiations in Canada’s lucrative resource extraction sector. A cumulative process occurs in which domestic and international expressions of political autonomy reinforce each other, produce further opportunities to express authority in both environments, and trouble the state’s capacity to fully realize its international policy preferences.

Women’s health Goulburn North East community crime prevention plan – regional preventing violence against women and children strategy: summative evaluation report from the external evaluator, February 2016

This report presents the external evaluation of the Hume Regional Preventing Violence Against Women Strategy. This is one of 12 projects funded by the Department of Justice and Regulation in Victoria under its initiative to support primary prevention and early intervention-focused partnership projects that seek to prevent violence before it occurs or address the key contributing factors of violence against women and their children. The focus is on changing behaviours and attitudes that allow violence against women and children to continue. The lead agency in the project was Women’s Health Goulburn North East (WHGNE).The Hume regional strategy The focus of the project was to develop and implement a coordinated regional strategy that addresses the determinants of violence against women and builds the capacity of communities to take action to prevent such violence. At the outset it was envisaged that a key component of the strategy would be to undertake preventive activities that respond to identified gaps in the region.The first version of the strategy was completed in September 2013 and formally launched in November 2013. In October 2013, Courageous Conversations was identified as the brand to be used for activities in the strategy, including a charter and other resources. As the project evolved, the strategy was revised to reflect differing levels of engagement and progress with the different parts of the work and to identity explicitly the activities associated with the brand. A revised version of the regional strategy was produced in September 2014, with four aims:• promoting equal and respectful relationships between men and women;• working across local government, workplaces and sporting settings to coordinate a region-wide approach to preventing violence against women;• bringing about structural and systemic organisational change to promote gender equitable and non-violent cultures;• build the capacity of leaders in preventing violence against women.Different components of the activities carried out under the strategy included: partnership and capacity building; building gender equity in organisations; gender equity and masculinities training; bystander training; knowledge dissemination and the Courageous Conversations website.

Teacher stories of collusion and transformation: a feminist pedagogical framework and meta-language for cultural gender justice

This article examines data from two different studies concerning issues of social justice, gender and schooling and specifically the practices of secondary teachers, ‘Mr B’, a teacher from a school in Tasmania, Australia, and ‘Mr C’, a teacher from a school in Bedfordshire in the United Kingdom. Both teachers’ practices and relationships with students are analysed within a feminist interpretation of the Productive Pedagogies model of quality teaching and learning. The two different stories are presented as juxtapositions that serve to illuminate the capacities of pedagogy to, on the one hand, work in ways likely to re-inscribe the discourses of entitlement and privilege that perpetuate cultural gender injustice, and on the other, transform these discourses towards more equitable and just networks of multiple and intersecting differences.