Australia's national men's health policy : masculinity matters

Issue addressed : The development of Australia's first national men's health policy provides an important opportunity for informed discussions of health and gender. It is therefore a concern that the stated policy appears to deliberately exclude hegemonic masculinity and other masculinities, despite evidence of their major influence on men's health-related values, beliefs, perspectives, attitudes, motivations and behaviour.

Methods : We provide an evidence-based critique of the proposed approach to a national men's health policy which raises important questions about whether the new policy can achieve its aims if it fails to acknowledge 'masculinity' as a key factor in Australian men's health.

Conclusion : The national men's health policy should be a means to encourage gender analysis in health. This will require recognition of the influence of hegemonic masculinity, and other masculinities, on men's health. Recognising the influence of 'masculinity' on men's health is not about 'blaming' men for 'behaving badly', but is crucial to the development of a robust, meaningful and comprehensive national men's health policy.

Generic medicines in Australia : business dynamics and recent policy reform

This article describes the role of generics in the Australian prescription drug market and patterns of business activity in this dynamic market segment. The Pharmaceutical Benefits Scheme (PBS) is the central mechanism for the supply of prescription medicines. PBS prices are arrived at through cost-effectiveness analyses comparing new products against already available products and therapies. In this system, prices do not operate effectively as incentives for consumers or prescribers to choose generics, and their market share was historically marginal. In recent years, generics suppliers achieved a growing market share through discounts (trading terms) to pharmacists. It is estimated that around 30% of PBS scripts, representing around 15% of PBS sales by value, are now filled with generics. Complex changes to the PBS were introduced in 2007, to be phased in over the period to 2012, aimed at increasing the scope for cost benefits to the government, and to lesser extent consumers, from the expanding availability of generic medicines.

Construction supply chain economic policy implementation for sectoral change : moving beyond the rhetoric

The improvement of the performance of the construction industry through the improved performance of the supply chains that make up the various sectors is a difficult task and one that has had considerable international debate (London, 2005). The idea of using the supply chain concept as a normative model to improve firm behaviour and thus ultimately industry performance through the development of supply chain clusters or integrated supply chains has been discussed in many public sector policy documents and in the academic research community since the late 1990s (London, 2005). However it has been difficult to see any real examples where this concept has had any major impact – or where the improvements have been measured and/or monitored.

Leaving the bush : why did they do it?

The demand for allied health professionals (AHPs) in rural areas is increasing due to changes in lifestyle, disease and disability of the population. Recruitment and retention of AHPs in rural Australia is an issue that continues to challenge policy makers. However, recent initiatives from the Commonwealth Government have focused on boosting the rural health workforce through grants that support education and training, expand health services and increase the number of rural and remote clinical placements. In addition to this funding, suggested restructure of the current allied health service delivery model is gaining much attention. Although this funding and organisational reform is much needed and welcomed, the changing nature of allied health work, increasing demand, and shortages across most rural areas highlight the need for research to address the complexities associated with recruitment and retention of these professionals.

Gaining insight into the experiences of rural AHPs can assist with enhancing government funded recruitment and retention programs and developing sustainable and efficient workforce policies. This study hopes to build on our previous research that implies recruitment is enhanced when retention is optimal, since AHPs are willing to recommend their workplace. Therefore, the factors that influence retention are just as valid and important as the factors that influence recruitment, but many of the existing workforce models have solely focused on recruitment.4 Additionally, these models do not adequately address issues regarding rural employment, they are difficult to implement, and costly to sustain.

In order to make policy recommendations on recruitment and retention in Australia, this paper aims to explore the experiences of AHPs who resigned from rural employment

Migrant youth, cultural adaptation and social policy

This introductory chapter will attempt to locate these conceptual debates within wider intellectual and research agendas. It will also try to examine the role social policy can play in shaping the life opportunities of young people. The roles of both government agencies and non-government organisations will be considered and discussed.

The trading dynamics of close-substitute futures markets : evidence of margin policy spillover effects

Volatility spillover is well documented among closely related securities. I investigate the relationship between margin policy and trading dynamics of the Nikkei 225 index futures markets of Osaka Securities Exchange (OSE) and Singapore Exchange (SGX). I find that OSE’s margin policy influences trading dynamics across both markets, although it is the less liquid SGX market that performs price discovery. This suggests that policy markers of close substitute markets should coordinate, or at least communicate policy intentions due to policy spillover. SGX’s market design facilitates price discovery, suggesting that a microstructure framework capable of overcoming the liquidity entry barrier is of interest to any futures exchange contemplating contract proliferation.

From what we know to how we use it : five principles for turning entrepreneurship research and practitioner action guidelines

This and the companion paper that follows owe their existence to a paper presented by Kevin Hindle at the AGSE Regional Entrepreneurship and Innovation Research Exchange in February 2004. In his paper, Hindle (2004) argued passionately that entrepreneurship researchers must ensure that the best of their hardwon wisdom does not find its beginning motivation and final resting place in the pages of arcane journals that practitioners never read. He suggested that if every entrepreneurship researcher committed, say once every two years, to write a "how to" article it would significantly enhance the status of the research community in the eyes of practising entrepreneurs and those who provide support and services to them.

The argument was well-received, particularly by two people in the audience, Robert Anderson, the managing editor of the Journal of Small Business and Entrepreneurship, the journal of the Canadian Council for Small Business and Entrepreneurship/Conseil Canadien des PME et de l'entrepreneuriat (CCSBE/ CCPME), and Brian Gibson, the editor of Small Enterprise Research, the journal of the Small Enterprise Association of Australia and New Zealand (SEAANZ). For both editors, Hindle's argument was a familiar one. The membership of CCSBE/CCPME and SEAANZ consists of academic researchers, educators, government employees in both policy and program areas, and those offering support and services to entrepreneurs and the managers of small enterprises. In both organizations, there is a general consensus that the needs of "academics" are well met, but not so the needs of the non-academic constituents.

The relationship between innovation and entrepreneurship : easy definition, hard policy

The paper argues that innovation is the combination of an inventive process and an entrepreneurial process to create new economic value for defined stakeholders and focuses on the policy implications of this duality. Attention is concentrated on summarising the entrepreneurial process and its importance to innovation policy and avoids any detailed elaboration of the invention process. A very brief overview of the invention process is followed by a moderately detailed summary of Hindle's (2008) model of entrepreneurial process. With an understanding and formal articulation of entrepreneurial process it becomes possible to focus on the key issues that ought to inform the development of innovation policy. These key issues are discussed and the paper concludes where it began by emphasising the need to build innovation policy on the explicit recognition that innovation results from the blending of two processes, invention and entrepreneurship, and that viable innovation policy can never be created unless entrepreneurial process is properly understood and addressed.

Australia's strengths and weaknesses in technology transfer and R&D exploitation : GEM survey "experts" views compared with public policy and other published data

There has been increasing public debate in Australia in recent years about research culture in universities and other publicly funded research agencies such as CSIRO and its impact on Australia's performance in generating economic, social and environmental benefits to the Australian community from the large amount of public funding for R&D. This is the supply side issue. On the demand side there is equally concern about the technology absorptive capacity of Australian. business as illustrated by the low proportion of gross business research expenditure (GERD) spent by business (BERD). Against this background, this paper has explored the views of abut 100 "experts" interviewed in the Australian Global Entrepreneurship Monitor (GEM) studies in the years 2000, 2001, 2002 and 2003 on the issues, strengths and weaknesses of Australia's technology transfer performance as it applies to new technology small firms. The paper has also explored evidence for any longitudinal change over this period.

Social networking, social harassment and social policy

This paper reports on the misuse of social networking sites (SNS). It was based on a study of 226 students in UK, Sweden, Turkey and France and a panel survey of 1068 Australian adults. Although only a minority of people experienced social harassment and abuse, the distressing nature of the bad experiences suggested that social marketing was needed on several fronts -self-regulation, regulation, education and personal responsibility - in order to minimise these behaviours.

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.

Australian dental policy reform and the use of dental therapists and hygienists

Oral diseases including dental caries and periodontal disease are among the most prevalent and costly diseases in Australia today. Around 5.4% of Australia’s health dollar is spent on dental services totalling around $2.6 billion, 84% of which are delivered through the private sector (AIHW 2001). The other 16% is spent providing public sector services in varied and inadequate ways. While disease rates among school children have declined significantly in the past 20 years the gains made among children are not flowing on to adult dentitions and our aging population will place increasing demands on an inadequate system into the future (AHMAC 2001). Around 50% of adults do not received regular care and this has implications for widening health inequalities as the greatest burden falls on lower income groups (AIHW DSRU 2001). The National Competition Policy agenda has initiated, Australia-wide, reviews of dental legislation applying to delivery of services by dentists, dental specialists, dental therapists and hygienists and dental technicians and prosthetists. The review of the Victorian Dentists Act 1972, was completed first in 1999, followed by the other Australian states with Queensland, the ACT and the Northern Territory still developing legislation. One of the objectives of the new Victorian Act is to ‘…promote access to dental care’. This study has grown out of the need to know more about how dental therapists and hygienists might be utilised to achieve this and the legislative frameworks that could enable such roles. This study used qualitative methods to explore dental health policy making associated with strategies that may increase access to dental care using dental therapists and hygienists. The study used a multiple case study design to critically examine the dental policy development process around the Review of the Dentists Act 1972 in Victoria; to assess legislative and regulatory dental policy reforms in other states in Australia and to conduct a comparative analysis of dental health policy as it relates to dental auxiliary practice internationally. Data collection has involved (I) semi-structured interviews with key participants and stakeholders in the policy development processes in Victoria, interstate and overseas, and (ii) analysis of documentary data sources. The study has taken a grounded theory approach whereby theoretical issues that emerged from the Victorian case study were further developed and challenged in the subsequent interstate and international case studies. A component of this study has required the development of indicators in regulatory models for dental hygienists and therapists that will increase access to dental care for the community. These indicators have been used to analyse regulation reform and the likely impacts in each setting. Despite evidence of need, evidence of the effectiveness and efficiency of dental therapists and hygienists, and the National Competition Policy agenda of increasing efficiency, the legislation reviews have mostly produces only minor changes. Results show that almost all Australian states have regulated dental therapists and hygienists in more prescriptive ways than they do dentists. The study has found that dental policy making is still dominated by the views of private practice dentists under elitist models that largely protect dentist authority, autonomy and sovereignty. The influence of dentist professional dominance has meant that governments have been reluctant to make sweeping changes. The study has demonstrated alternative models of regulation for dental therapists and hygienists, which would allow wider utilisation of their skills, more effective use of public sector funding, increased access to services and a grater focus on preventive care. In the light of theses outcomes, there is a need to continue to advocate for changes that will increase the public health focus of oral health care.

Treaties as tools of foreign policy : a psychopolitical inquiry via Keatings's vision for Australia

Paul Keating will be remembered by some Australians as a visionary. As Prime Minister he outlined the structure of external and domestic reform that he believed would guarantee global security for all Australians. Driving these reforms, more often than not, were interstate agreements, often in the form of multilateral treaties, sometimes in the guise of bilateral compromise, rarely as unilateral declarations. In areas as diverse as collaborative scientific research or the protection of children in the workplace, the Keating Executive set out, through codification, to transform Australia’s political landscape. The fields of trade, military, environmental and human rights were all included in the attempts by Keating to forge a new image of and for Australia in the Asia Pacific region. Treaties were vital agents of change in this milieu in the bid to reformulate regional perceptions of Australia. The path of inquiry in this thesis stemmed from a quest to examine the origin, role, purpose and efficacy of treaties in the Keating Government’s foreign policy aimed at regional military security. In order to make this examination it develops a polyphonic1 analytical model whose purpose is to explore the psychopolitical underpinnings of these agreements. Thus the thesis has a two fold task. To develop an analytical model of how treaties work as tools of foreign policy and to outline and assess the Keating treaty strategy. Its principal contribution is on the theoretical side.

Policy framework for a knowledge society : families and knowledge

My thesis examines the link between families, harm and knowledge in a society where knowledge is increasingly the central organising principle (Bohme 1997: 449-450; Stehr 1994: 6), and represents the capacity for action (Stehr 1994: 8). I observed as a consultant in the 1990s that practitioners in family work were able to articulate what works but often unable to articulate why and therefore unable easily to replicate what works. This time coincided with increasing commentary on complexities of living, capacity of families to cope, identification of the scale of family harm, and use of the term 'the knowledge society'. My aim is to identify why what works, works with families exhibiting harmful behaviours and families acquiring knowledge from learning everyday life skills so as to lead less harmful and more fulfilling lives. And by such explanations inform, replicate and scale up practice to benefit more families exhibiting harm. I conceptualise the outcome as a sequence of family, community and policy work in an ecological framework (Bronfenbrenner 1979) within a knowledge society. My method was a year-long action research project with a family support service in New South Wales. I engaged in reflective practice with workers, and a parallel literature review that supported additional reflective practice. I found growing complexity of life requires growing knowledge. I found a distinction between everyday and abstract life worlds, and with families principally acting in the everyday life world. It is a world from which some families and their members seek to escape, often by means of harmful behaviours of neglect, abuse and violence. I substantiated the link that the family support service of my study sees between relationships, behaviours and affects; and I linked this in turn with its therapeutic engagement of the whole family — adults and children, male and female, victims and perpetrators. This engagement involves a process of learning (Rogers 1967: 280) to acquire fulfilling behaviours. It is a process of adult and experiential learning of relationship skills, drawing on under-used reserves of families. Relationship skills form a basis of acquiring other life skills since most require relationships with others to perform life skills. Combining the sequence of family, community and policy work with workers engaging in reflective practice of their work creates capacity for community institutions to replicate and scale up what works and why. Understanding this sequence may assist community institutions to inform policymakers of benefits common to all policy interests of such replication and scaling up. I conceptualise a policy framework of families and knowledge in a knowledge society and two lower level frameworks of process and content of life skills. Implications of these for practice, policy, and theory include a greater distinction between everyday and abstract knowledge and skills; recognition of a sequential process of information, learning, and knowledge; and inclusiveness and fluidity in learning in diverse adult learning settings and in family support professions.

Principalship and policy in small New Zealand primary schools

This research investigates the relationship between principalship and policy in small New Zealand primary schools. A distinctive feature of small primary schools is that their principals typically have to teach as well as manage. Overseas research indicates that in times of educational reform, teaching principals face particular difficulty and may need special support. Following the watershed educational reforms of 1989 and a decade of ‘hands-off’ policy in education (1989-1999), central policy towards school support in New Zealand is now more ‘hands-on’. The impact of this policy change on small schools has not been researched hi New Zealand, where such schools make up over fifty percent of all primary schools. The aims of this study are to analyse the impact of current support policy in New Zealand on small primary school principalship, and to evaluate the extent to which policy adjustment might be needed in the future. Using multiple methods and a case study approach to gather data, the study focuses on small school principalship in one New Zealand region - the Central Districts region. It also considers the recent policy initiatives, their rationale and the extent to which they appear to be meeting the support needs reported by the principals whose work has been researched in the study. Broadly, the study has found that within small schools, the role-balance within a teaching principal’s work is a critical factor, as the ratio within the principal’s role-balance between the teaching role and the management role creates variation in work-demands, work-strategies and types of support needed. Teaching principals in New Zealand generally feel better supported now than they did in the 1990s and the study identifies factors associated with this change. However the analysis in this study suggests that the current policy aim to both rationalise and strengthen the small school network as a whole is rather problematic. Without better targeted support policy in this area, old style parochial and competitive attitudes between schools are unlikely to change in the future.