Public health interventions in midwifery: a systematic review of systematic reviews

Background: Maternity care providers, particularly midwives, have a window of opportunity to influence pregnant women about positive health choices. This aim of this paper is to identify evidence of effective public health interventions from good quality systematic reviews that could be conducted by midwives.

Methods: Relevant databases including MEDLINE, Pubmed, EBSCO, CRD, MIDIRS, Web of Science, The Cochrane Library and Econlit were searched to identify systematic reviews in October 2010. Quality assessment of all reviews was conducted.

Results: Thirty-six good quality systematic reviews were identified which reported on effective interventions. The reviews were conducted on a diverse range of interventions across the reproductive continuum and were categorised under: screening; supplementation; support; education; mental health; birthing environment; clinical care in labour and breast feeding. The scope and strength of the review findings are discussed in relation to current practice. A logic model was developed to provide an overarching framework of midwifery public health roles to inform research policy and practice.

Conclusions: This review provides a broad scope of high quality systematic review evidence and definitively highlights the challenge of knowledge transfer from research into practice. The review also identified gaps in knowledge around the impact of core midwifery practice on public health outcomes and the value of this contribution. This review provides evidence for researchers and funders as to the gaps in current knowledge and should be used to inform the strategic direction of the role of midwifery in public health in policy and practice.

Is the public healthcare sector a more strenuous working environment than the private sector for a physician?

Aims: The present study examined the differences between physicians working in public and private health care in strenuous working environments (presence of occupational hazards, physical violence, and presenteeism) and health behaviours (alcohol consumption, body mass index, and physical activity). In addition, we examined whether gender or age moderated these potential differences. Methods: Cross-sectional survey data were compiled on 1422 female and 948 male randomly selected physicians aged 25-65 years from The Finnish Health Care Professionals Study. Logistic regression and linear regression analyses were used with adjustment for gender, age, specialisation status, working time, managerial position, and on-call duty. Results: Occupational hazards, physical violence, and presenteeism were more commonly reported by physicians working in the public sector than by their counterparts in the private sector. Among physicians aged 50 years or younger, those who worked in the public sector consumed more alcohol than those who worked in the private sector, whereas in those aged 50 or more the reverse was true. In addition, working in the private sector was most strongly associated with lower levels of physical violence in those who were older than 50 years, and with lower levels of presenteeism among those aged 40-50 years. Conclusions: The present study found evidence for the public sector being a more strenuous work environment for physicians than the private sector. Our results suggest that public healthcare organisations should pay more attention to the working conditions of their employees.

Public Interests, Private Disputes: Investment Arbitration and the Public Good

This paper seeks to investigate the bases for resistance to arbitration in general -and investor arbitration in particular- focusing on the way in which arbitral tribunals deal with notions of public interest and the public good. The paper hypothesises that while courts have within their terms of reference the capacity to consider notions of public interest, arbitral tribunals do not. It is this core difference in the scope of decision making between the two bodies that could render privately organised dispute resolution unsuitable for disputes that have public aspects, like investor-state disputes. The paper discusses the meaning of public interest and the public good as found in the literature. It then proceeds to consider how tribunals in the investment field have dealt with these concepts. This leads to a conclusion urging not abandonment of arbitration as a component of dispute resolution, but caution. It is argued that unchecked growth in private dispute resolution can threaten perceptions of legitimacy and democratic accountability. The paper adopts a socio-legal methodology in considering the effect of legal mechanisms on social and political phenomena. It is also informed by a law and economics methodology in addressing impacts of dispute resolution mechanisms on economic efficiency. The contribution of the paper rests on theorising motivations for resistance to private dispute resolution, a topical issue in light of the TTIP debate.

The neo-liberal state and the crisis of public service broadcasting in the Anglo-American democracies /

The NeO'liberal State and the Crisis ofPublic Service Broadcasting in the Anglo-American Democracies The purpose ofthis analysis ofthe present condition ofpublic service broadcasting in the Anglo- American democracies was to investigate whether such media can still be regarded as the primarypublic spherefor a dialogue between each nation 's civil society and the State. The motivationfor this thesis was based on a presumption that such fora for public discussion on the central issues of each society have become viewed as less relevant bypoliticians andpolicy-makers and thepublics they were intended to serve in the Anglo-American democracies over thepast two decades. It is speculated that this is the case because ofa beliefthat the post-war consensus between the respective States andpublics that led to the construction of the Keynesian Welfare State and the notion ofpublic service broadcasting has been displaced by an individualistic, neo-liberal, laissez-faire ideology. In other words, broadcasting as a consumer-oriented, commercial commodity has superseded concerns pertaining to the importance ofthe public interest. The methodology employed in this thesis is a comparative analysisfrom a criticalpolitical economy perspective. It was considered appropriate to focus on the United Kingdom, Australia, Canada and the\ United States because they comprise the four largest Anglo-American nations with democratic political systems andprimarily market economies. Justificationfor this particular sample is reinforced by thefact that case study countries also share a common socio-political and economic tradition. The evidence assembledfor this thesis consisted almost exclusively ofexisting literature on the subjects ofpublic service broadcasting, global economic andpolitical integration, and the ascendance ofthe 'free-market ' ethos in Western democracies since the late mid- to late-1970s. In essence, this thesis could be considered as a reinterpretation ofthe existing literature relevant to these issues. Several important common features werefound among the political, economic and broadcasting systems of the four case study nations. It is proposed that the prevalence of the neo-liberal world view throughout the political and policy environments of the four countries has undermined the stability and credibility of each nation 's national public service broadcasting organization, although with varying intensity and effect,. Deregulation ofeach nation 's broadcasting system and the supremacy ofthe notion of 'consumer sovereignty' have marginalized the view of broadcasting on any basis other than strictly economic criteria in thefour case study countries. This thesis concludes that,for a reconstruction ofa trulyparticipatory anddemocraticpublicsphere to be realized in the present as well as thefuture, a reassessment ofthe conventional concept ofthe 'public sphere ' is necessary. Therefore, it is recommended that thefocus ofpolicy-makers in each Anglo-American democracy be redirectedfrom that which conceived ofan all-encompassing, large, state-ownedand operated public broadcasting service toward a view which considers alternativeforms ofpublic communication, such as local community and ethnic broadcasting operations, that are likely to be more responsive to the needs of the increasingly diverse and heterogeneous populations that comprise the modem Anglo-American democracies. The traditional conception of public broadcasters must change in accordance with its contemporary environment if the fundamental principles of the public sphere and public service broadcasting are to be realized.

Impacts de l'action du groupe environnemental Eau Secours! sur les politiques québécoises relatives à l'eau

Cet essai vise à mesurer la portée, sur les décisions politiques, de l’action d’un groupe environnemental qui se préoccupe de dossiers liés à l’eau. Le groupe à l’étude, appelé Eau Secours! est un groupe d’intérêt public qui a vu le jour en 1997. Nous proposons de vérifier si les actions du groupe lui permettent d’atteindre ses objectifs et nous tenterons ensuite d’examiner son répertoire d’actions. L’analyse de quatre dossiers est privilégiée : la privatisation de la gestion des eaux municipales, l’exportation massive d’eau à l’extérieur du Québec, le programme de construction de mini-centrales hydroélectriques privées, et l’élaboration d’une politique de l’eau en accord avec les principes du développement durable. Les résultats de l’étude montrent que l’utilisation par le groupe environnemental des médias de masse et le recours à des réseaux lui ont permis d’obtenir des effets positifs en ce qui a trait aux décisions gouvernementales. Cependant la participation du groupe à une consultation publique a entraîné des résultats mitigés. De manière générale, cette étude de cas montre la complexité de la relation entre un groupe environnemental et des acteurs gouvernementaux engagés à différents niveaux.

Les opérations scrutées sous l'angle de l'intérêt public par les organismes de réglementation des valeurs mobilières : entre efficience et duplicité

"Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de Maîtrise en droit (LL.M) option droit des affaires"

Les considérations environnementales dans l'arbitrage d'investissement sous l'égide du CIRDI

L’arbitrage international, outre le recours aux tribunaux de l’État hôte, est la méthode la plus utilisée pour régler les différends relatifs aux investissements étrangers. Plusieurs accords internationaux d’investissement incluent des dispositions ayant trait à l’arbitrage sous l’égide du Centre International pour le Règlement des Différends relatifs aux Investissements (CIRDI) mis en place par la Convention de Washington de 1966. Les tribunaux arbitraux constitués sous l’égide du Centre sont ainsi appelés à trancher des différends qui concernent la conduite d’États hôtes vis-à-vis ses investisseurs étrangers ; leurs décisions ayant de fortes conséquences sur l’intérêt public, concrètement lorsqu’il s’agit de la protection de l’environnement. L’évolution croissante du droit environnemental et son empiètement sur la protection des investissements a déclenché une série de différends qui ne se limitent plus à mettre en cause des nationalisations ou des violations de contrats - comme auparavant - mais tournent souvent autour de mesures étatiques de politique publique qui impliquent des questions sensibles telles que, inter alia, la gestion de déchets dangereux, l’accès à l’eau potable, l’étalement urbain, la protection de la biodiversité. Par conséquent, le rôle des tribunaux CIRDI et de leurs décisions devient décisif dans le développement du droit des investissements et dans le débat sur la protection des investissements face aux mesures législatives en matière environnementale. Cette étude a pour objet d’analyser la place des considérations environnementales dans les sentences arbitrales CIRDI. Spécifiquement, il s’agit d’étaler les principaux arguments retenus par les tribunaux internationaux, et de dégager les grandes tendances jurisprudentielles en matière d’arbitrage international d’investissements face aux mesures environnementales.

Offensive advertising, public policy, and the law: the rulings on the Zagorka case

This paper examines the case of a controversial beer advertisement which was promulgated in Bulgaria in 2001, and which provoked eight lawsuits against the brewery, its advertising agency, and the Bulgarian National Television. The case set a precedent in Bulgaria and generated considerable public interest and debate. To the best of the authors’ knowledge this is the first case in Eastern Europe when individuals have challenged companies in the courts of law because of offence caused by an advertisement. The present study discusses how the public bodies responsible for protecting consumer interests and the courts of first instance assessed the advertisement in the context of Bulgarian public policy regarding offensive advertising.

Terahertz pulse imaging of stratified architectural materials for cultural heritage studies

Terahertz pulse imaging (TPI) is a novel noncontact, nondestructive technique for the examination of cultural heritage artifacts. It has the advantage of broadband spectral range, time-of-flight depth resolution, and penetration through optically opaque materials. Fiber-coupled, portable, time-domain terahertz systems have enabled this technique to move out of the laboratory and into the field. Much like the rings of a tree, stratified architectural materials give the chronology of their environmental and aesthetic history. This work concentrates on laboratory models of stratified mosaics and fresco paintings, specimens extracted from a neolithic excavation site in Catalhoyuk, Turkey, and specimens measured at the medieval Eglise de Saint Jean-Baptiste in Vif, France. Preparatory spectroscopic studies of various composite materials, including lime, gypsum and clay plasters are presented to enhance the interpretation of results and with the intent to aid future computer simulations of the TPI of stratified architectural material. The breadth of the sample range is a demonstration of the cultural demand and public interest in the life history of buildings. The results are an illustration of the potential role of TPI in providing both a chronological history of buildings and in the visualization of obscured wall paintings and mosaics.

For the public without the public

How is the notion of public interest operationalised in the regulatory practices of the International Public Sector Accounting Standards Board (IPSASB)? A fundamental objective in setting international accounting standards for both the private and public sector is to serve the ‘public interest’. Who or what constitutes ‘public interest’ however remains a highly complex and controversial issue. Private sector financial reporting research posits that users (of financial information) are used as a proxy for the ‘public’ and users are further refined to current and potential investors - a small proportion of the public. The debates surrounding public interest are even more contentious in public sector financial reporting which deals with ‘public’ (tax payers’) money. In our study we use Bourdieu’s notion of semi-homogenous fields to show how autonomous and heteronomous pressures from the epistemic community of the accounting profession and political/government interests compete for the right to define the public interest and determine how (by what accounting solutions) this interest is best served. This is a theoretical study grounded in the analysis of empirical data from interviews with the board members of the IPSASB. The main contribution of the paper is to further our understanding of the perceptions of the main decision makers from the ‘inner regulatory circle’ with regards to the problematic construct of public interest. The main findings suggest a paternal and un-reflexive attitude of the board members leading to the conclusion that the public have no real voice in these matters.

The national interest in international relations theory

The concept of the 'national interest' is an ever-present feature of contemporary diplomatic discourse, and has been widely analysed by historians and political scientists. However, there has not been a systematic investigation of the term from the range of theoretical perspectives which comprise the discipline of International Relations. This book fills this gap by explaining how the term is variously understood by realist, Marxist, anarchist, liberal rationalist (English School) and constructivist theories of International Relations. It is argued that far from having a clear and unambiguous meaning, 'the national interest' is a problematic term which is largely devoid of substantive content. While realists traditionally, and constructivists more recently, claim that 'the national interest' is a key explanatory tool in the analysis and understanding of contemporary foreign policy.
Scott Burchill argues that beyond the narrow aspect of security policy, the national interest has little residual value as an insight into the motivations of state policy in the external realm.

The emergence of the public sector expectations gap

This paper focuses on the continuing worldwide phenomenon of homogenisation of audit rules, regulation and procedures between the government and private sectors. The observations are informed by Pusey’s (1991) criticisms of ‘economic rationalism’ as the driving mechanism behind public sector reforms in Australia. The presumed superiority of commercial audit is questioned in association with the work of Hopwood (1983, 1998), Otley and Pierce (1996) and, Power (1992, 1994, 1995, 1996, 1997) that contextualise the role of audit. In the private sector audit there continues to be an ‘expectations gap’ arising from commercial pressures and a rhetorical support for the public interest. It is contended that audit quality in the public sector is driven by a different perception of public interest that has been eroded with the advent of economic rationalism. The consequent emergence of a public sector audit ‘expectations gap’ is an amalgam of new components particular to the government audit environment and, aspects of the private ‘expectations gap’ which have been transplanted into the public domain.

On the governance of public education

Private schools in Australia receive significant public funding, but their determination to concentrate social and cultural capital and consolidate positional advantage ‘denies the possibility of their serving the public interest’. A 1998 study of Victorian private schools has confirmed that they produce above-average academic results and are also concentrated in high socioeconomic geographic areas. The few private schools outside this pattern serve mainly provincial areas or ethnic minority groups. High academic credentials depend at least in part on their scarcity, and ‘the selective function of schools, directed towards establishing a hierarchy of performance, overwhelms the pedagogical function of universal learning and social justice,’ especially at transition points in the education system. The governance procedures of schools typically encourage high academic standards ‘through mechanisms of exclusion’. Private schools in particular, at the secondary level, tend to ‘export failure’ through ‘predatory recruitment and selective dumping practices’, and by arrangements with universities for early placement of high performers into preferred tertiary courses. The broader education system reinforces the competitive processes within schools though competitive examinations. A range of steps can address these equity problems. Curriculum should be made more sensitive to disadvantaged social groups. Secondary schools should be aligned more closely to the social, cultural and economic development of their communities through mechanisms such as VET in schools, linkages with TAFE colleges, and a broadened curriculum that addresses community problems.