Early users of fertility treatment with hormones and IVF : women who live in major cities and have private health insurance

Objective: To identify early users (women aged <34 years) of fertility treatment with hormones and in vitro fertilisation (IVF). Methods: A cross-sectional survey of infertile women from fertility clinics (n=59) and from the community (Australian Longitudinal Study on Women's Health participants) who had (n=121) or had not (n=110) used hormones/IVF as treatment for infertility. Associations between socio-demographic, reproductive and lifestyle factors, medical conditions and recurrent symptoms and using treatment (or not) were analysed using multivariable logistic regression. Results: Among infertile women who had used treatment (community vs clinic), women from clinics had lower odds of living outside major cities, using hormones only, i.e., not IVF, or recurrent headaches/migraines, severe tiredness, or stiff/painful joints; and higher odds of recent diagnoses of urinary tract infection or anxiety disorder. Compared to infertile women who had not used treatment, women from clinics had lower odds of living outside major cities, recurrent allergies or severe tiredness; and higher odds of having private health insurance for hospital or ancillary services, recent diagnosis of polycystic ovary syndrome or recurrent constipation. Conclusions: Compared to infertile women in the community, living in major cities and having private health insurance are associated with early use of treatment for infertility at specialist clinics by women aged <34 years. Implications: These results provided evidence of inequity of services for infertile women.

Learning how to be responsive to public policy issues affecting SSSI members

Human survival depends on human ingenuity in using resources at hand to sustain human life. The historical record – in wrings and archaeological artefacts – provides evidence of the growth and collapse of political organisations and societies. In the institutions of Western civilisation, some traditions have endured over millennia where the roles of monarchs and public officials have been organised in perpetual succession. These roles were developed as conventions in the British Parliament after 1295 and provided the models of corporate governance in both public and private enterprise that have been continuously refined to the present day. In 2011, the Queensland Parliament legislated to introduce a new and more open system of scrutiny of legislation through a system of portfolio-based parliamentary committees. The committees began to function more actively in July 2012 and have inviting submissions from stakeholders and experts in a structured way to consider the government’s priorities in its legislative programme. The questions now are whether the Surveying and Spatial Sciences can respond expertly to address the terms of reference and meet the timetables of the various parliamentary committees. This paper discusses some of the more important and urgent issues that deserve debate that the profession needs to address in becoming more responsive to matters of public policy.

Conflict and seduction in the public sphere

In a critical but sympathetic reading of Habermas’s work (1984, 1987a, 1987b, 2003), Luke Goode (2005) recently sought to rework his theory of deliberative democracy in an age of mediated and increasingly digital public spheres. Taking a different approach, Alan McKee (2005) challenged the culture- and class-bound strictures of Habermasian rationalism, instead pursuing a more radically pluralist account of postmodern public spheres. The editors of this special section of Media, Culture & Society invited us to discuss our differing approaches to the public sphere. Goode holds that the institutional bases of contemporary public spheres (political parties, educational institutions or public media) remain of critical importance, albeit in the context of a kaleidoscopic array of unofficial and informal micro-publics, both localized and de-territorialized. In contrast, McKee sustains a ‘hermeneutics of suspicion’ toward the official, hegemonic institutions of the public sphere since they tend to exclude and delegitimize discourses and practices that challenge their polite middle-class norms. McKee’s recent research has focused on sexual cultures, particularly among youth (McKee, 2011). Goode’s recent work has examined new social media spaces, particularly in relation to news and public debate (e.g. Goode, 2009; Goode et al., 2011). Consequently, our discussion turned to a domain which links our interests: after Goode discussed some of his recent research on (in)civility on YouTube as a new media public sphere, McKee challenged him to consider the case of pornographic websites modelled on social media sites.1 He identifies a greater degree of ‘civility’ in these pornographic sibling sites than on YouTube, requiring careful consideration of what constitutes a ‘public sphere’ in contemporary digital culture. Such sites represent an environment that shatters the opposition of public and private interest, affording public engagement on matters of the body, of intimacy, of gender politics, of pleasure and desire – said by many critics to be ruled out of court in Habermasian theory. Such environments also trouble traditional binaries between the cognitive and the affective, and between the performative and the deliberative. In what follows we explore the differences between our approaches in the form of a dialogue. As is often the case, our approaches seemed less at odds after engaging in conversation than may have initially appeared. But important differences of emphasis remain.

The determinants of demand for private health insurance under Medicare

Since the introduction of Medicare in 1984, the proportion of the Australian population with private health insurance has declined considerably. Insurance for health care consumption is compulsory for the public health sector but optional for the private health sector. In this paper, we explore a number of important issues in the demand for private health insurance in Australia. The socio-economic variables which influence demand are examined using a binary logic model. A number of simulations are performed to highlight the influence and relative importance of various characteristics such as age, income, health status and geographical location on demand. A number of important policy issues in the private health insurance market are highlighted. First, evidence is provided of adverse selection in the private health insurance pool, second, the notion of the wealthy uninsured is refuted, and finally it is confirmed that there are significant interstate differences in the demand for private health insurance.

Speaking truth to power : sexism, outrage and the public consciousness

Alan Jones's now infamous comment that women are destroying the joint' sparked a flurry of observations and interpretations in the national and international media and in the blogosphere about the motivations and meanings of such a statement. The overriding tone of this commentary was outrage - how dare an influential figure like Jones state with such blatant and provocative hostility that women are at best unsuitable for leadership and at worst, damaging our public and private institutions? The answers, as we have seen, are likely to be complex, but an alternative question could also be posed. Why the outrage? Public male figures have, throughout history, made derogatory, demeaning and sexist remarks about women, and the material effects of gender inequality continue to be felt- consider the gender pay gap and glass ceiling phenomenon for starters. So why did this particular comment ignite such widespread indignation and anger?

Volunteers 'piggy-backing' on their private insurance : an uncertain protection against liability

Volunteering is a very important part of life in Australia with an estimated 36% of the adult population volunteering in 2010. Voluntary work generates economic benefits, addresses community needs and develops the social networks that form the backbone of civil society. Without volunteers, many essential services would either cease to exist or become too expensive for many people to afford. These volunteers, who by definition are not in receipt of any remuneration for their work and services, are exposed to personal injury and to legal liability in the discharge of their functions. It is therefore appropriate that statutory protection is extended to volunteers and that volunteer organisations procure public liability and personal accident cover where possible. However, given the patchwork quilt of circumstances where statutory or institutional cover is available to volunteers and the existence of many and diverse exclusions, it is important to have regard also to what scope a volunteer may have to avail themselves of protection against liability for volunteering activity by relying upon their own personal insurance cover. This article considers the extent of private insurance cover and its availability to volunteers under home and contents insurance and under comprehensive motor vehicle insurance. The most common policies in the Australian market are examined and the uncertain nature of protection against liability afforded by these policies is discussed. This uncertainty could be reduced should the Federal Government through amendments to the Insurance Contracts Regulations standardise the circumstances and extent to which liability protection was afforded to an insured holding home and contents insurance and comprehensive motor vehicle insurance cover.

Private hospital emergency departments in Australia : challenges and opportunities

BACKGROUND: Public hospital EDs in Australia have become increasingly congested because of increasing demand and access block. Six per cent of ED patients attend private hospital EDs whereas 45% of the population hold private health insurance. OBJECTIVES: This study describes the patients attending a small selection of four private hospital EDs in Queensland and Victoria, and tests the feasibility of a private ED database. METHODS: De-identified routinely collected patient data were provided by the four participating private hospital and amalgamated into a single data set. RESULT: The mean age of private ED patients was 52 years. Males outnumbered females in all age groups except > 80 years. Attendance was higher on weekends and Mondays, and between 08.00 and 20.00 h. There were 6.6% of the patients triaged as categories 1 and 2, and 60% were categories 4 or 5. There were 36.4% that required hospital admission. Also, 96% of the patients had some kind of insurance. Furthermore, 72% were self-referred and 12% were referred by private medical practitioners. Approximately 25% arrived by ambulance. There were 69% that completed their ED treatment within 4 h. CONCLUSION: This study is the first public description of patients attending private EDs in Australia. Private EDs have a significant role to play in acute medical care and in providing access to private hospitals which could alleviate pressure on public EDs. This study demonstrates the need for consolidated data based on a consistent data set and data dictionary to enable system-wide analysis, benchmarking and evaluation

Natural disaster risk-informed for a better public infrastructure asset planning in Indonesian Central Government

The natural disasters incident that frequently hit Indonesia are floods, severe droughts, tsunamis, earth-quakes, volcano, eruptions, landslides, windstorm and forest fires. The impact of those natural disasters are significantly severe and affecting the quality of life of the community due to the breakdown of the public as-sets as one source to deliver public services. This paper is aimed to emphasis the importance of natural disaster risk-informed in relation to public asset management in Indonesian Central Government, particularly in asset planning stage where asset decision is made as the gate into the whole public asset management processes. A Case study in the Ministry of Finance Indonesia as the central government public asset manager and in 5 (five) line ministries/governmental agencies as public asset users was used as the approach to achieved the research objective. The case study devoured three data collection techniques i.e. interviews, observations and document archival which will be analysed by a content analysis approach. The result of the study indicates that Indonesian geographical position exposing many of public infra-structure assets as a high vulnerability to natural disasters. Information on natural-disaster trends and predictions to identify and measure the risks are available, however, such information are not utilise and integrated to the process of public infrastructure asset planning as the gate to the whole public asset management processes. Therefore, in order to accommodate and incorporate this natural disaster risk-information into public asset management processes, particularly in public asset planning, a public asset performance measurements framework should be adopted and applied in the process as one sources in making decision for infrastructure asset planning. Findings from this study provide useful input for the Ministry of Finance as public asset manager, scholars and private asset management practitioners in Indonesia to establish natural disaster risks awareness in public infrastructure asset management processes.

The most private private education : home education in Australia

In Australia, the decision to home educate is becoming increasingly popular (cf. Townsend, 2012). The popularity of home education is in spite of a large number of publically funded, financially affordable private and public schools that offer a range of educational alternatives to parents (cf. English, 2009). In spite of its increasing popularity, the reasons home education is chosen by Australian families is under-researched (cf. Jackson & Allan, 2010). This paper reports on a case study that set out to explore the reasons Australian parents choose to home educate and whether this decision is related to the choice of a private school in Australia. In-depth, qualitative interviews were conducted with a group of home education families in one of Australia’s most populated cities. Data were thematically analysed. The analysis revealed that there were similarities between the discourses of parents who privately educate and parents who home educate. In particular, it reveals the parents’ fears about schools, their negative experiences of schools and their hopes for their children’s futures.

A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention

Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first (‘minimal’) step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second (‘expanded’) step assesses the nutritional composition of each organization's products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third (‘optimal’) step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention.

Public Economics and the Assessment of Tourism Developments and Policies

Public economics covers both topics in welfare economic of social (as opposed to private) interest and aspects of public finance. This chapter considers the application of two methods of social economic evaluation of tourist developments, namely, social cost-benefit analysis and economic impact analysis. The role of social cost-benefit analysis in the assessment of tourism is illustrated by its application to the evaluation of inbound tourism. This is followed by a discussion of taxes on tourism and subsidies to promote it. The principle focus is on hotel room taxes. The analysis of taxes on tourism involves both public finance and welfare economics issues. The scope for and desirability of applying the user-pays principle to tourism is then examined.

Distributed public-key cryptography from weak secrets

We introduce the notion of distributed password-based public-key cryptography, where a virtual high-entropy private key is implicitly defined as a concatenation of low-entropy passwords held in separate locations. The users can jointly perform private-key operations by exchanging messages over an arbitrary channel, based on their respective passwords, without ever sharing their passwords or reconstituting the key. Focusing on the case of ElGamal encryption as an example, we start by formally defining ideal functionalities for distributed public-key generation and virtual private-key computation in the UC model. We then construct efficient protocols that securely realize them in either the RO model (for efficiency) or the CRS model (for elegance). We conclude by showing that our distributed protocols generalize to a broad class of “discrete-log”-based public-key cryptosystems, which notably includes identity-based encryption. This opens the door to a powerful extension of IBE with a virtual PKG made of a group of people, each one memorizing a small portion of the master key.

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.

Public Finance for REDD+ in Kenya

Kenya aims to prepare for both public and private Reduced Emission from Deforestation and Degradation (REDD+) investment flows. This chapter examines how current Kenyan law can be used as a starting point for building a regulatory regime to support public sector finance. For present purposes, ‘public sector finance’ is defined as money flowing from multilateral international institutions and bi-lateral donor funds. Key issues addressed by this chapter • The nature and form of public sector finance for REDD+ in Kenya. • The management and laws relating to public funds in Kenya; • Mechanisms that can be utilised to manage risk associated with REDD+ investments with a focus on Kenyan anti-corruption laws and policies; • The regulatory regime for distributing the benefits from REDD+ investment to relevant forest stakeholders.

Competition paper. Prostitution and public health in New South Wales

Using historical and contemporary resources, this paper provides a critical account of the contemporary governance of prostitution in New South Wales. A Foucauldian approach is used to analyse the ways in which prostitution has been problematized as a health issue and managed as a public health problem. The analysis differs from other critical studies of prostitution in that it examines specific techniques of power, the operations of which have not been confined to the workings of a repressive criminal justice system. It is shown that there currently co-exists two broad understandings of prostitution in New South Wales, Australia, which have informed current initiatives to manage prostitution. Prostitutes working in public spaces have been presented as sexual agents wilfully engaged in criminal conduct and the spread of contagion. They have been subject to intense official scrutiny and regulated through criminal sanctions. In contrast, prostitutes working in private spaces have been presented as victims of adverse circumstance, deserving of protection and compassion. They have been made subject to strategic interventions that have attempted to normalize prostitution and render the prostitute a hygienic subject.