Impact of shifts in health policy on the role and practice of generalist community health nurses

Provides a critical analysis of trends in health policy which are impacting on the role and practice of generalist community nurses in Victoria. The thesis draws on critical social theory to research and analyse trends in health policy in relation to the Community Health Program.

Entrepreneurship : industry policy priorities and entrepreneurial education in Australia

Four fields of national policy - general economic policy, industry policy, education policy and specific research and development policy - are strongly interrelated. Unfortunately, in Australia, policy makers in the four fields have not recognized that the discipline of Entrepreneurship - with its emphasis on managing the innovation process - holds the key to effective co-ordination between the four vital policy areas. The paper argues that innovation strategy, not cost reduction or research expenditure, is the key to developing successful, export-oriented products and world competitiveness. Viable innovation strategy depends on the relationship between government, capital availability, development capital and industrial developers. In turn, this relationship requires a cadre of entrepreneurial business managers educated not in the 'traditional' MBA mainstream but in the discipline of Entrepreneurship, specifically focused on learning the practical skills involved in venture evaluation and management of the innovation process. The paper concludes by describing the philosophy and performance of Swinburne University of Technology's School of Innovation and Enterprise, a school at the forefront of entrepreneurial education in Australia and thus a school with important implications for the nation's industry policy priorities.

Introduction : consumer groups and the democratization of health policy

This book examines the important role of consumer activism within health policy in different national contexts. In an age of shifting boundaries between state and civil society, consumer groups are potentially drivers of democratization in the health domain. The expert contributors explore how their activities bring new dynamics to relations between service providers, the medical profession, government agencies, and other policy actors. This book is unique in comprehensively analysing the opportunities and dilemmas of this type of activism, including ambiguous partnerships between consumer groups and stakeholders such as the pharmaceutical industry. These themes are explored within an internationally comparative framework, with case studies from various countries. Students and researchers in the fields of health policy and sociology, public policy and social movements will find this relevant and path-breaking book enlightening. It will also prove invaluable for participants and activists in patient and health consumer organizations.

Engaging with Asia : the Chifley government and the New Delhi conferences of 1947 and 1949

This article is a study of the Chifley government's foreign policy towards Asia, in particular India and Indonesia, as evidenced by Australia's attendance at the 1947 Asian Relations Conference and the 1949 New Delhi Conference on the Indonesian-Dutch conflict. Australia's presence at these two conferences provides an ideal opportunity to examine the Chifley government's response to the momentous changes that occurred in post-war Asia as a result of the dismantling of the European colonial world order. Through detailed examination of the archival material and contemporary accounts generated from Australia's involvement in the New Delhi conferences, this article will argue that despite significant political constraints, the Chifley government did adopt a distinctive and innovative policy towards the emergent nations of Asia in the immediate post-war years.

The mutual obligation policy in Australia : the rhetoric and reasoning of recent social security policy

Since 1997, the Australian Federal Liberal Government has introduced policies which have sought to reduce rates of unemployment, particularly long-term unemployment. The policy, known as Mutual Obligation, increased the expectations on unemployed people in return for their social security payment. At the same time, previous labour market programmes and government assistance schemes were scrapped or privatised. This article explores the justification of the term 'Mutual Obligation' by examining both the language and the underlying principles of the policy. By defining the problem of unemployment in terms of flaws in the previous social security system, the stage is set for the government to introduce policies which remedy those flaws by emphasising self- reliance in favour of government assistance. Further, by invoking notions of fairness and mutuality, the article argues that the term 'Mutual Obligation' masks both the extent and the strength of the obligations imposed on unemployed people.

A study of older Australians’ volunteering and quality of life : empirical evidence and policy implications

Older Australians are confronted by dramatic changes in their physical, social, financial, and psychological well-being. There are social costs to these changes related to their productivity and increased costs associated with caring for older Australians. Greater community engagement through voluntary work practice may minimize these costs, as well as positively influence volunteers' subjective quality of life (QOL). This study investigates the motivations for older Australians to engage in formal voluntary work. It seeks to identify whether the motivational factors to volunteer are associated with individuals' subjective QOL. The results indicate a positive relationship between older people's motivations to volunteer and their subjective QOL. This association is strengthened by respondents' community orientation, positive perception of voluntary work, positive personal attitudes toward volunteering, and their self-esteem. The role of policy makers in motivating larger participation by the older groups is discussed.

Regulation to create environments conducive to physical activity : understanding the barriers and facilitators at the Australian State Government level

Introduction Policy and regulatory interventions aimed at creating environments more conducive to physical activity (PA) are an important component of strategies to improve population levels of PA. However, many potentially effective policies are not being broadly implemented. This study sought to identify potential policy/regulatory interventions targeting PA environments, and barriers/facilitators to their implementation at the Australian state/territory government level.

Methods In-depth interviews were conducted with senior representatives from state/territory governments, statutory authorities and non-government organisations (n = 40) to examine participants': 1) suggestions for regulatory interventions to create environments more conducive to PA; 2) support for preselected regulatory interventions derived from a literature review. Thematic and constant comparative analyses were conducted.

Results Policy interventions most commonly suggested by participants fell into two areas: 1) urban planning and provision of infrastructure to promote active travel; 2) discouraging the use of private motorised vehicles. Of the eleven preselected interventions presented to participants, interventions relating to walkability/cycling and PA facilities received greatest support. Interventions involving subsidisation (of public transport, PA-equipment) and the provision of more public transport infrastructure received least support. These were perceived as not economically viable or unlikely to increase PA levels. Dominant barriers were: the powerful ‘road lobby’, weaknesses in the planning system and the cost of potential interventions. Facilitators were: the provision of evidence, collaboration across sectors, and synergies with climate change/environment agendas.

Conclusion This study points to how difficult it will be to achieve policy change when there is a powerful ‘road lobby’ and government investment prioritises road infrastructure over PA-promoting infrastructure. It highlights the pivotal role of the planning and transport sectors in implementing PA-promoting policy, however suggests the need for clearer guidelines and responsibilities for state and local government levels in these areas. Health outcomes need to be given more direct consideration and greater priority within non-health sectors.

Boom and bust in Australian screen policy: 10BA, the Film Finance Corporation, and Hollywood's 'race to the bottom'.

In recent years, a narrative has emerged in the Australian popular media about the box office 'unpopularity' of Australian feature films and the 'failure' of the domestic screen industry. This article explores the recent history of Australian screen policy with particular reference to the '10BA' tax incentive of the 1980s; the Film Finance Corporation of Australia (FFC), a government screen agency established in 1988 to bring investment bank-style portfolio management to Australia's screen industry; and local production incentive policies pursed by Australian state governments in a chase for Hollywood's runaway production.

We argue the 10BA incentive catalysed an unsustainable bubble in Australian production, while its policy successor, the FFC, fundamentally failed in its stated mission of 'commercial' screen financing (over its 20-year lifespan, the FFC invested 1.345 billion Australian dollars for 274.2 million Australian dollars recouped - a cumulative return of negative 80 percent). For their part, private investors in Australian films discovered that the screen production process involved high levels of risk.

Foreign-financed production also proved highly volatile, due to the vagaries of trade exposure, currency fluctuations and tax arbitrage. The result of these macro and micro-economic factors often structural and cross-border in nature was that Australia's screen industry failed to develop the local investment infrastructure required to finance a sustainable, non-subsidised local sector.

'Everybody has settled in so well': How migrants make connections and build social capital in Geelong

Australian and Victorian Government policies encourage settlement in regional areas for international migrants, refugees and internal migrants. Migrants to regional areas are diverse in terms of their area or country of origin, skills and occupation, family status and other demographic characteristics. The regional cities to which they migrate are also varied in terms of their community resources, social and cultural capital. The objective shared by all of these cities is for migrants to engage successfully with their new communities. Just how this occurs is the subject of debate and a lack of clarity. This therefore calls for a sound, theoretically informed understanding of how employers and community groups (formal and informal) can effectively assist migrants to make social connections in regional cities, and practical strategies which respond to these insights. The well-established social determinants of health tell us that the more socially included, connected and stable workforce and their families are, the better will be their physical and mental health and wellbeing.

An exercise in good government: Fukuzawa Yukichi on emigration and nation-building

Fukuzawa Yukichi penned a series of articles from 1884 to 1896 on why the Japanese must emigrate and settle abroad. Most striking is Fukuzawa's opposition to any legislation preventing the movement of Japanese subjects abroad, including rural women who migrated with the purpose of engaging in prostitution abroad. According to Fukuzawa, the challenge facing Japanese government policy makers was not at what point do you say "no" to poor rural women migrating abroad, but the opposite, at what point should you say "yes."

Utilization of a population health survey in policy and practice: a case study

Background
There is growing interest by funding bodies and researchers in assessing the impact of research on real world policy and practice. Population health monitoring surveys provide an important source of data on the prevalence and patterns of health problems, but few empirical studies have explored if and how such data is used to influence policy or practice decisions. Here we provide a case study analysis of how the findings from an Australian population monitoring survey series of children’s weight and weight-related behaviors (Schools Physical Activity and Nutrition Survey (SPANS)) have been used, and the key facilitators and barriers to their utilization.

Methods
Data collection included semi-structured interviews with the chief investigators (n = 3) and end-users (n = 9) of SPANS data to explore if, how and under what circumstances the survey findings had been used, bibliometric analysis and verification using documentary evidence. Data analysis involved thematic coding of interview data and triangulation with other data sources to produce case summaries of policy and practice impacts for each of the three survey years (1997, 2004, 2010). Case summaries were then reviewed and discussed by the authors to distil key themes on if, how and why the SPANS findings had been used to guide policy and practice.

Results
We found that the survey findings were used for agenda setting (raising awareness of issues), identifying areas and target groups for interventions, informing new policies, and supporting and justifying existing policies and programs across a range of sectors. Reported factors influencing use of the findings were: i) the perceived credibility of survey findings; ii) dissemination strategies used; and, iii) a range of contextual factors.

Conclusions
Using a novel approach, our case study provides important new insights into how and under what circumstances population health monitoring data can be used to influence real world policy and practice. The findings highlight the importance of population monitoring programs being conducted by independent credible agencies, researchers engaging end-users from the inception of survey programs and utilizing existing policy networks and structures, and using a range of strategies to disseminate the findings that go beyond traditional peer review publications.

Community views on responding to a local asbestos disease epidemic : implications for policy and practice

The Latrobe Valley region of Victoria, Australia, has the highest rate of asbestos disease in the state due to extensive past use of asbestos in the power industry. Current responses to asbestos disease epidemics in Australia and internationally are dominated by medical, scientific, legal and government perspectives. The voices and perspectives of those most directly affected – exposed and diseased workers, their families and communities – are relatively rarely heard.A qualitative interview study was conducted to determine what people in the Latrobe Valley community think could or should be done following their own asbestos disease epidemic. Analysis identified several themes. Notably, these represent a sophisticated community understanding of issues that is largely consistent with state-of-the-art occupational health and public health knowledge.Some themes are well known already, eg the need for fair and timely compensation, adequate healthcare facilities and services, and more education. Others point to neglected possibilities, such as the need for reconciliation and social healing to complement the dominant individual medico-legal focus. Employer suppression of hazard information and denial of asbestos-related disease in past decades continues to have a profound effect on people's views in the present. Reconciliation in some form, eg acknowledgement of or apology for past wrongs, was identified as a necessary first step in developing new and better policy and practice responses; action in this regard has important implications for the implementation and effectiveness of other policy and practice interventions. Further, a need for substantive community participation in the development of policy and practice responses – currently lacking – was identified. Findings suggest that community is an under-recognised and under-utilised resource in responding to a local asbestos disease epidemic.The Latrobe Valley situation is a microcosm of the broader Australian and international story. It offers insights on the perspectives of those most affected by asbestos issues, how such people and their views can be used to strengthen current policy and practice responses, and how their participation is essential to building comprehensive public and social health responses to this global problem.

Neoliberalism, economic restructuring and policy change : precarious housing and precarious employment in Australia

Housing, employment and economic conditions in many nations have changed greatly over the past decades. This paper explores the ways in which changing housing markets, economic conditions and government policies have affected vulnerable individuals and households, using Australia as a case study. The paper finds a substantial number and proportion of low income Australians have been affected by housing and employment that is insecure with profound implications for vulnerability. Importantly, the paper suggests that in Australia the economic gains achieved as a consequence of mining-related growth in the early 2000s were translated as greater employment security for some on low incomes, but not all. Enhanced access to employment in this period was differentiated by gender, with women largely missing out on the growth in jobs. For the population as a whole, employment gains were offset by increased housing insecurity as accommodation costs rose. The paper finds low income lone parents were especially vulnerable because they were unable to benefit from a buoyant labour market over the decade 2000–2010. They were also adversely affected by national policy changes intended to encourage engagement with paid work. The outcomes identified for Australia are likely to have been mirrored in other nations, especially those that have embraced, or been forced to adopt, more restrictive welfare and income support regimes.

Aboriginal people and local government. A Shepparton story

Sequential governments have created policies to deal with the "Aboriginal problem". None of these have been particularly successful. I contend that the absence of effective dialogue has been the cause of most failures. I also argue that future policies will also fail unless a dialogic approach of deep listening, respect and love is adopted.