Dissertations / Theses on the topic 'Public health administration – Australia'
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1
Leon, de la Barra Sophia. "Building research capacity for indigenous health : a case study of the National Health and Medical Research Council : the evolution and impact of policy and capacity building strategies for indigenous health research over a decade from 1996 to 2006." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/3538.
Full textAbstract:
As Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.
2
Leon, de la Barra Sophia. "Building research capacity for indigenous health : a case study of the National Health and Medical Research Council : the evolution and impact of policy and capacity building strategies for indigenous health research over a decade from 1996 to 2006." University of Sydney, 2007. http://hdl.handle.net/2123/3538.
Full textAbstract:
Master of PhilosophyAs Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.
3
Sorensen, Ros Public Health & Community Medicine Faculty of Medicine UNSW. "The dilemma of health reform : managing the limits of policymaking, managerialism and professionalism in health care reform." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2002. http://handle.unsw.edu.au/1959.4/33194.
Full textAbstract:
Hospitals worldwide are under pressure to perform and models abound to remedy poor performance. Reform, however, is contested, uneven and slow. One reason is that few models address a core issue in reform: the management of clinical work. A further reason is that stakeholder groups, specifically policymakers, managers and clinicians, limit opportunities for collaborative problem solving as they seek to impose their own frame of reference in the struggle for control. I hypothesise that performance will be relatively better in hospitals that have in place strategies of agreement to set the objectives of reform, such as participative problem identification, problem solving and decision making, together with a method to manage clinical work. This hypothesis was tested in twelve public hospitals in three Australian states between 1999 and 2001 using both quantitative and qualitative research methods. Government and hospital policy documents were assessed and semi-structured interviews were conducted to gauge the attitudes and practices of managers and clinicians regarding health care reform. The results of the research show that hospitals with inclusive strategies for change, principally strategies of agreement, joint education and skills development, team-based incentives to direct and reward effort and a method of clinical work management, performed better than those without. Findings indicate that policy was developed and communicated as a rational top-down process that tended to exclude diverse views. Although the effect of different jurisdictional policy processes on hospital performance was not clear, they had considerable impact on the environment of reform. Cost containment and patient safety dominated as policy objectives. These alone did not engage clinician interest or address service quality. The connection between the quality of care and its cost did not appear to be understood. Organisational structures and processes necessary to support reform, that is communication forums for objective setting and performance review, integrated clinical and corporate accountability systems and organisational capacity building were not in place in the majority of hospitals studied. An organisational model of clinical work management was developed to improve cost-effectiveness by balancing clinical autonomy and clinical accountability based on the research results.
4
Kelman, Christopher William, and christopher kelman@cmis csiro au. "Monitoring Health Care Using National Administrative Data Collections." The Australian National University. National Centre for Epidemiology and Population Health, 2001. http://thesis.anu.edu.au./public/adt-ANU20020620.151547.
Full textAbstract:
With the inevitable adoption of information technology into all areas of human pursuit, the potential benefits for health care should not be overlooked. In Australia, details of most health care encounters are currently recorded for administrative purposes. This results in an impressive electronic data-bank that could provide a national resource for health service evaluation.
¶
Evaluation of health services has become increasingly important to provide indicators of the benefits, risks and cost-effectiveness of treatments. However, if administrative data are to be used for this purpose, several questions must first be addressed: Are the current data collections accessible? What outcome measures can be derived from these data? Can privacy issues be managed? Could the quality of the data be improved? Is the existing infrastructure adequate to supply data for evaluation purposes? Could the existing system provide a basis for the development of an integrated health information system?
¶
The aims of the project were:
· To examine the potential for using administrative data to generate outcome measures and surveillance indicators.
· To investigate the logistics of gaining access to these data for the purpose of research. This to be achieved within the current ethical, political and financial framework.
· To compare the Australian health-service data system with the current international state-of-the-art.
· To develop suggestions for expansion of the present system as part of an integrated health record and information system. This system to manage patient records and provide data for quality management, treatment surveillance and cost-effectiveness evaluation as a routine activity.
¶
The thesis is presented in two parts. In the first part, a historical cohort study is described that involved patients with implantable medical devices. The potential to evaluate outcomes was investigated using all national health-service information currently available in electronic form. Record linkage techniques were used to combine and augment the existing data collections. Australias national health databases are to varying degrees, amenable to such linkage and cover doctor visits, pharmaceuticals, hospital admissions and deaths. The study focused on medical devices as an illustrative case but the results are applicable to the routine assessment of all medical and surgical interventions.
¶
For the Australian Medical Devices study, the records of 5,316 patients who had medical device implants in 1993-94 were selected from the archives of a major private health insurer. Five groups of medical implants were studied: heart valves, pacemakers, hips, vascular grafts and intra-optic lenses. Outcomes for these patients, including death, re-operation and health service utilisation, were compared and analysed.
¶
A comparison study was performed using data from the Manitoba Health database in Winnipeg, Canada. Manitoba provides a very similar demographic group to that found in Australia and is an example of a prototype integrated-health-information system. One of the principal advantages for research is that personally identified data about medical and hospital services are collected for all patients. Selection bias is eliminated because individual consent is not required for this type of research and all selected patients could be included in the study.
¶
The two studies revealed many barriers to the use of administrative data for health outcomes research. Service event data for the Australian cohort could be collected but only after long delays and hospital morbidity data were not available for the entire cohort. In contrast to the situation in Australia, the Manitoba data were both accessible and complete, but were lacking in detail in some areas.
¶
Analysis of the collected data demonstrated that without the addition of clinical data only general indications of trends could be deduced. However, with minimal supplementary clinical data, it was possible to examine differences in performance between brands of medical devices thus indicating one of the uses for this type of data collection.
¶
In the second part of the thesis, conclusions are presented about the potential uses and limitations of the existing system and its use as a basis for the development of a national Integrated Health Record and Information System (IHRIS). The need for the establishment of a systemic quality management system for health care is discussed.
¶
The study shows that linked administrative data can provide information about health outcomes which is not readily available from other sources. If expanded and integrated, the system that is currently used to collect and manage administrative data, could provide the basis for a national health information system. This system would provide many benefits for health care. Benefits would include the monitoring, surveillance and cost-effectiveness analysis of new and existing treatments involving medical devices, drugs and surgical procedures. An integrated health information system could thus provide for both clinical and administrative needs, while in addition providing data for research.
¶
Unfortunately, in Australia, the use of administrative data for this purpose is not currently feasible. The principal barrier is the existence of a culture within the Australian health care system which is not supportive of research and is deficient in quality and safety measures.
¶
Recent initiatives by both the Commonwealth and state governments have supported the introduction of measures to improve quality and safety in health care. It is argued here that an Integrated Health Record and Information System (IHRIS) would provide an essential component of any such scheme. The results of this study have important policy implications for health care management in both the administrative and clinical domains.
5
Polley, Anne. "An exploration of the critical success factors associated with implementing a Public Health Plan in Local Governments within Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2019. https://ro.ecu.edu.au/theses/2227.
Full textAbstract:
Public Health planning in local governments in Western Australia (WA) is a relatively new approach to addressing local health needs. The Western Australian Public Health Act came into effect in 2016. The Public Health Act 2016 encompasses a range of legislative requirements, some of which include the development of Local Public Health Plans. A range of roles within the local government workforce therefore are likely to require support to plan and implement Public Health Plans, which in the past have not directly been a component of their role. There is limited understanding and evidence of the barriers and enablers that contribute to effective implementation of Public Health Plans in the Western Australian context. The research aims to determine the critical success factors associated with implementing Public health Plans in local governments within Western Australia.
This exploratory study encompassed a series of case studies from local governments in Western Australia that had implemented a Public Health Plan. Data was collected via in-depth interviews and document analysis. The results of this study articulate local government staff perspectives about the challenges and barriers faced when implementing a Public Health Plan. This study informs discussion around the training and resource requirements of staff in local governments in WA tasked with the development and implementation of Local Public Health Plans.
6
Backhouse, Peter. "Medical knowledge, medical power : doctors and health policy in Australia /." Title page, contents and abstract only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09phb126.pdf.
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7
Nield, Robert, and n/a. "Alientated students' perceptions of school organizational health." University of Canberra. Education, 1990. http://erl.canberra.edu.au./public/adt-AUC20060824.130208.
Full textAbstract:
This thesis explores alienated students' perceptions of the organizational health of a
Year 7 to 10 A.C.T. high school. The study emerged at the theoretical level from a
concern that school effectiveness studies focussed too narrowly on student academic
attainment as an indicator of an effective school. A broader view of effectiveness
would hopefully show that in the case of comprehensive co-educational government
high schools, student alienation could have a powerful effect in undermining the
achievement of academic goals in such schools.
Because these schools have little control over their student clientele and require
compulsory student attendance until age 15, it seemed a degree of alienation was
inevitable. The task for high school administrators, it was hypothesized, lay in
minimizing these alienation levels in order to reduce the impact such student
alienation might have on other school effectiveness indicators like teacher
commitment, teacher morale and time on task in classes.
My experience as a practitioner, in the Student Welfare area of a large ACT
government high school, also indicated that the traditional "top down" strategy of
much research in the field of Educational Administration that concentrated on the
perspectives of principals and teachers only gave one view of the processes within a
school. The other, complementary "bottom up" view came from students. In
particular, it was hypothesized, the perspectives the most alienated students in a
government high school held towards the organizational health of the school might
represent an unusual test of school effectiveness.
This was because the commitment of such students towards the school and its stated
academic goals was most problematic. The promotion of a school "culture" or
"ethos" that could integrate low level and high level alienation students, and thereby
foster school effectiveness, appeared to be possible only to the extent that high level
alienation students could be kept on side or neutralized by high school
administrators.
These speculations were largely confirmed in this study. Apart from the interaction
of sex and year level with alienation, the other major finding was that teacher
consideration, or the extent to which teachers show concern for students as
individuals, was the only organizational health dimension that produced a significant
difference between students on the basis of alienation level.
In short, the study is not concerned with student alienation as such. Rather it is
concerned with understanding how alienated students perceive a relatively effective
school. This would hopefully enable that alienation to be minimized and managed.
8
Jackson, Pulver Lisa Rae. "An argument on culture safety in health service delivery towards better health outcomes for Aboriginal peoples /." University of Sydney. Public Health and Community Medicine, 2003. http://hdl.handle.net/2123/609.
Full textAbstract:
The bureaucratic measure of health service, health performance indicators, suggest that we are not effective in our legislative responsibility to deliver suitable health care to some of the populations we are meant to serve. Debate has raged over the years as to the reasons for this, with no credible explanation accepted by those considered stakeholders. One thing is clear though, we have gone from being a culture believing that the needs of the many far outweigh those of the few, to one where we are barely serving the needs of the 'any'. This is most evident in the care delivered to the Aboriginal and Torres Strait Islander people of Australia.
9
Jackson, Pulver Lisa Rae. "An argument on culture safety in health service delivery: towards better health outcomes for Aboriginal peoples." Thesis, The University of Sydney, 2003. http://hdl.handle.net/2123/609.
Full textAbstract:
The bureaucratic measure of health service, health performance indicators, suggest that we are not effective in our legislative responsibility to deliver suitable health care to some of the populations we are meant to serve. Debate has raged over the years as to the reasons for this, with no credible explanation accepted by those considered stakeholders. One thing is clear though, we have gone from being a culture believing that the needs of the many far outweigh those of the few, to one where we are barely serving the needs of the 'any'. This is most evident in the care delivered to the Aboriginal and Torres Strait Islander people of Australia.
10
Ngwenya, Bigboy. "Causes and effects of physical injuries to Prison Officers employed in a high risk and high need offender management environment in Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2012. https://ro.ecu.edu.au/theses/492.
Full textAbstract:
Prison Officers (POs) involved in high need offender management frequently face risks that could affect their health, safety and wellbeing. Several studies have shown that direct client centred violence, inadequate management systems and the general nature of prison environments are major factors impacting on the well being of POs (Fisher & Gunnison, 2001; Kiekbusch, Price, & Theis, 2003; Mitchell, Mackenzie, Styve, & Gover, 2000).There is limited literature on causes and effects of physical injuries on this group of law enforcements officers. This is the first study conducted in Western Australia (WA) that investigated the causes and effects of physical injuries to POs and the impacts thereof on these individuals and the Department of Corrective Services (DCS) as an organisation. The study aimed to provide a recent credible data source which may influence policy decisions and procedures in WA corrective institutions. The study cohort of 146 POs completed a questionnaire that included variables, such as health and fitness, job demands, support and constraints to ascertain the causes and effects of physical injuries among this high risk cohort of workers. The age range of POs included in the study cohort (N = 146) was 21 - 71 years. In addition, all Department of Correctional Services (DCS) physical injuries databases from 2008 to 2010 were analysed and managers and employee welfare services staff completed a questionnaire. The results indicated that there is a positive relationship between current employment status and work related physical injuries as measured over the last two years. The major causes of physical injuries were from slips trips and falls and hitting objects with part of the body or against objects during the process of managing non compliant prisoners. Variables such as physical fitness, job demands, lack of recognition by society, and fear of blood borne infections were significant predictors of physical injuries amongst POs. However, a number of other risk factors, including age and body mass index (BMI), were not related to the prevalence of physical injuries. There are a number of recommendations from the study that can be implemented. These include formation of accident/incident investigation work groups to conduct and analyse incidents and propose long term preventive and corrective measures. In order to improve ways of dealing with mentally ill prisoners and the training curriculum of POs should include management of mentally ill prisoners in a prison setting. In dealing with the aging population affecting the Australian workforce, DCS should develop plans to attract young POs for succession planning. Comprehensive safe physical training and maintenance programs in prisons may benefit the POs in dealing with prisoners. Areas for future research may include; the role of mental health services in reducing physical harm in prisons and minimising the causes and effects of physical injuries to the prison frontline workforce.
11
Murphy, Angela University of Ballarat. "When urban policy meets regional practice : Evidence based practice from the perspective of multi-disciplinary teams working in rural and remote health service provision." University of Ballarat, 2004. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12747.
Full textAbstract:
"In the main, contemporary research on Evidence Based Practice (EBP) has taken place within metropolitan locations, and has offered urbocentric solutions and insights. However the transferability of these developments to rural services is untested empirically. In addition, evidence development and studies on the implementation of this evidence have tended to be discipline-stream-specific; there has been very little research into either the development of multi-disciplinary evidence guidelines or the implementation of EBP from the perspective of individual practitioners working within multi-disciplinary teams. This research shortfall has provided the rationale for this study...."Doctor of Philosophy
12
Murphy, Angela. "When urban policy meets regional practice : Evidence based practice from the perspective of multi-disciplinary teams working in rural and remote health service provision." Thesis, University of Ballarat, 2004. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/67365.
Full textAbstract:
"In the main, contemporary research on Evidence Based Practice (EBP) has taken place within metropolitan locations, and has offered urbocentric solutions and insights. However the transferability of these developments to rural services is untested empirically. In addition, evidence development and studies on the implementation of this evidence have tended to be discipline-stream-specific; there has been very little research into either the development of multi-disciplinary evidence guidelines or the implementation of EBP from the perspective of individual practitioners working within multi-disciplinary teams. This research shortfall has provided the rationale for this study...."Doctor of Philosophy
13
Murphy, Angela. "When urban policy meets regional practice : Evidence based practice from the perspective of multi-disciplinary teams working in rural and remote health service provision." University of Ballarat, 2004. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/14586.
Full textAbstract:
"In the main, contemporary research on Evidence Based Practice (EBP) has taken place within metropolitan locations, and has offered urbocentric solutions and insights. However the transferability of these developments to rural services is untested empirically. In addition, evidence development and studies on the implementation of this evidence have tended to be discipline-stream-specific; there has been very little research into either the development of multi-disciplinary evidence guidelines or the implementation of EBP from the perspective of individual practitioners working within multi-disciplinary teams. This research shortfall has provided the rationale for this study...."Doctor of Philosophy
14
English, Linda M. "Public private partnerships : modernisation in the Australian public sector." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/4985.
Full textAbstract:
Public private partnerships [PPPs] are a product of policies and processes to modernise the delivery of infrastructure-based services. An examination of the modernisation literature establishes the broad analytical frame within which this thesis investigates PPPs. The macro-level overview of the recent transformation of the Australian public sector confirms that the dominant principles underlying modernisation are grounded in new institutional economics [NIE] that are implemented through private-sector derived accounting and management implementation technologies. It highlights the contextual complexities stemming from Australia’s federal system of government, explaining the decision to focus on investigating PPP experiences in Victoria. At the conceptual level, PPPs rely on risk management and modernisation of service delivery to achieve value for money [VFM] for governments. In Victoria, 2000 signals a change in the modernisation role of PPPs. Thereafter, risk inherent in PPPs was reduced by excluding the contractor from the delivery of core social services. Also, the state began to develop a number of PPP policies to guide, aid, control and rationalise decision making in the pre-contracting stage, and to clarify objectives. Analysis of PPP contracts and the failure of one pre-2000 PPP hospital project are illustrative of the controversies identified in the literature about ‘hidden’ aims, the role of technologies designed provide ‘objective’ evidence of VFM inherent in PPPs at the time of contracting, and the ‘fallacy’ of risk transfer to private contractors. An examination of prison contracts indicates the changing nature of the management and control of PPPs in the execution stage. Analysis of pre-2000 prison contracts reveals that these projects were intended to drive significant financial and nonfinancial modernisation reforms throughout the correctional services system. Despite problems with contractual specification of performance and payment mechanisms, and the failure of one of the three pre-2000 prisons, recent evidence suggests, contrary to conclusions in the previous literature, that sector-wide modernisation objectives are being achieved in PPP prisons. PPPs have been criticised on the grounds that they enable governments to avoid accountability for service provision. A survey of the extent, focus and characteristics of the performance audit of PPPs confirms that little PPP auditing has been undertaken in Australia per se, and also that much of the performance auditing has focused on examining adherence to mandated procedures in the pre-contracting stage. However, this thesis demonstrates that the Victorian government has undertaken significant evaluation of the operation of its pre-2000 PPP prisons, and that its thinking and policy development reflect lessons learnt. The evidence presented in this thesis challenges findings in the previous literature that modernisation has delivered less than promised. This thesis confirms the potency of longitudinal research to investigate outcomes of what is essentially an iterative process of reform and that ‘successful’ implementation of modernisation change is sensitive to the context to be reformed. In finding that the presence of goodwill trust is critical to the implementation of recent modernisation reform in the correctional services sector (including in the PPP prisons), this thesis also confirms recent critiques of the power of NIE theories to explain contracting practices in the PPP setting.
15
English, Linda M. "Public private partnerships : modernisation in the Australian public sector." University of Sydney, 2008. http://hdl.handle.net/2123/4985.
Full textAbstract:
Doctor of PhilosophyPublic private partnerships [PPPs] are a product of policies and processes to modernise the delivery of infrastructure-based services. An examination of the modernisation literature establishes the broad analytical frame within which this thesis investigates PPPs. The macro-level overview of the recent transformation of the Australian public sector confirms that the dominant principles underlying modernisation are grounded in new institutional economics [NIE] that are implemented through private-sector derived accounting and management implementation technologies. It highlights the contextual complexities stemming from Australia’s federal system of government, explaining the decision to focus on investigating PPP experiences in Victoria. At the conceptual level, PPPs rely on risk management and modernisation of service delivery to achieve value for money [VFM] for governments. In Victoria, 2000 signals a change in the modernisation role of PPPs. Thereafter, risk inherent in PPPs was reduced by excluding the contractor from the delivery of core social services. Also, the state began to develop a number of PPP policies to guide, aid, control and rationalise decision making in the pre-contracting stage, and to clarify objectives. Analysis of PPP contracts and the failure of one pre-2000 PPP hospital project are illustrative of the controversies identified in the literature about ‘hidden’ aims, the role of technologies designed provide ‘objective’ evidence of VFM inherent in PPPs at the time of contracting, and the ‘fallacy’ of risk transfer to private contractors. An examination of prison contracts indicates the changing nature of the management and control of PPPs in the execution stage. Analysis of pre-2000 prison contracts reveals that these projects were intended to drive significant financial and nonfinancial modernisation reforms throughout the correctional services system. Despite problems with contractual specification of performance and payment mechanisms, and the failure of one of the three pre-2000 prisons, recent evidence suggests, contrary to conclusions in the previous literature, that sector-wide modernisation objectives are being achieved in PPP prisons. PPPs have been criticised on the grounds that they enable governments to avoid accountability for service provision. A survey of the extent, focus and characteristics of the performance audit of PPPs confirms that little PPP auditing has been undertaken in Australia per se, and also that much of the performance auditing has focused on examining adherence to mandated procedures in the pre-contracting stage. However, this thesis demonstrates that the Victorian government has undertaken significant evaluation of the operation of its pre-2000 PPP prisons, and that its thinking and policy development reflect lessons learnt. The evidence presented in this thesis challenges findings in the previous literature that modernisation has delivered less than promised. This thesis confirms the potency of longitudinal research to investigate outcomes of what is essentially an iterative process of reform and that ‘successful’ implementation of modernisation change is sensitive to the context to be reformed. In finding that the presence of goodwill trust is critical to the implementation of recent modernisation reform in the correctional services sector (including in the PPP prisons), this thesis also confirms recent critiques of the power of NIE theories to explain contracting practices in the PPP setting.
16
Wagner, Steven M. "Public Sponsored Health Insurance to Improve Health Outcomes with Implications for Government Health Policy, Design, and Decision Making." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1002.
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This research sought to ascertain the extent to which providing public sponsored health insurance (PSHI) to previously uninsured Mexican-American Hispanics improves health outcomes among those requiring ongoing treatment to control diabetes. Prior research utilizing insurance access theory; access, equity, and health outcome interrelationship theory; health affordability theory; and financial and resource burden theory suggests the uninsured receive less care than the insured, with delayed treatment, leading to chronic conditions. This research tested each of those major theoretical constructs into a blended conceptual framework based on the notion that providing health insurance helps alleviate the disabling effects of diabetes among this population. This study used an unobtrusive, longitudinal, one group pretest-posttest design. Research questions were designed to measure the strength of the relationship between PSHI and patient health outcomes using physical examination data, laboratory results, and diagnosis of 712 diabetic patients with 5,300 medical visits over 3 years before and after enrolling for PSHI. Logistic regression was used to analyze data related to age, gender, time enrolled in PSHI, and service location relative to health outcomes. Findings support the theories that accessibility increases with the provision of health insurance but also show that health outcomes do not improve after enrollment in a PSHI. This study contributes to the body of knowledge in public health policy and administration by quantifying the strength and significance of the relationship between health insurance and health outcomes and effects positive social change by measuring the effectiveness of legislation providing the uninsured with health insurance in order to improve health outcomes.
17
Wood, Judith, and n/a. "The emergence of 'information management' in Australian public administration." University of Canberra. Administrative Studies, 1995. http://erl.canberra.edu.au./public/adt-AUC20061110.165502.
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Fleming, Brian James. "The social gradient in health : trends in C20th ideas, Australian Health Policy 1970-1998, and a health equity policy evaluation of Australian aged care planning /." Title page, abstract and table of contents only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phf5971.pdf.
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Wright, Trudy, and n/a. "Primary health care : the health care system and nurse education in Australia, 1985-1990." University of Canberra. Education, 1994. http://erl.canberra.edu.au./public/adt-AUC20061110.171759.
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Primary health care as a model for the provision of health services was
introduced by the World Health Organization In the mid 1970s. Initially
viewed as a means of health promotion and advancement of wellness in
developing countries., it was soon to be adopted by industrialised countries to
assist in relieving the demand on acute care services. This was to be achieved
through education of the community towards good health practices and the
preparation of nurses to practice in the community, outside of the acute care
environment Australian nurses were slow to respond to this philosophy of
health care and this study has sought to examine why this is so. It has been
found that there are a multitude of reasons for the lack of action In the decade
or more following the Declaration of Alma Ata and the major Issues have been
identified and elaborated.
Some of the major reports of the time that were associated with and had some
Influence on health care and nurse education have been examined to identify
recommendations and how much they support the ethos of primary health
care. These include the Sax committee report of 1978 and a submission by
the Department of Employment and Industrial Relations In 1987.
As part of the investigation, nursing curricula from around Australia in the
mid 1980s have been examined to determine the degree of the primary health
care content according to guidelines recommended by the World Health
Organization. It was found that generally at that time, there was a deficit In
the preparation of undergraduate students of nursing for practice In the area
of primary health care when the world, including industrialised nations, was
making moves towards this model of health care delivery.
Factors Influencing the slow response of nursing have been examined and
finally recommendations for further studies have been put forward.
20
Sinclair, Andrew. "The primary health care experiences of gay men in Australia." Connect to this title online, 2006. http://adt.lib.swin.edu.au/public/adt-VSWT20060713.084655/.
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Sinclair, Andrew James, and n/a. "The primary health care experiences of gay men in Australia." Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060713.084655.
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The present research, consisting of two studies, was designed to examine the
primary health care experiences of gay men in Australia and assess doctors? attitudes and
training with regard to gay men and their health care. In the first study, 195 gay men were
surveyed regarding their health issues and their primary health care experiences. The
most important health concerns of gay men were stress and depression followed by
HIV/AIDS, body image disorder and other sexually transmissible infections. Including
those participants who were unsure, approximately one-half reported experiencing
homophobia and almost one?quarter reported experiencing discrimination in the
provision of health care. Despite this, respondents were generally satisfied with their
primary health care, although respondents felt that all GPs should receive additional
undergraduate medical education regarding gay men?s health. In the second study, 25
doctors (13 gay specialists and 12 non-gay specialists) were surveyed regarding their
knowledge of gay men?s health and their comfort working with gay men. Non-gay
specialist GPs were less comfortable treating gay men, reported poorer communication
and were more homophobic than their gay specialist counterparts. Further, doctors
perceived their medical education regarding gay men?s health has been inadequate.
Together, the results of the two current studies suggest that disclosure of sexuality is an
important issue for both gay men and doctors, and has the potential to impact on the
quality of health care that gay men receive. In order to improve the level of disclosure,
the pervasiveness of homophobia and discrimination in primary health care must be
reduced. Finally, the results indicate that medical education must be updated to reflect
current knowledge regarding the health issues of gay men. Failure to address these issues
will condemn gay men to continued health inequality.
22
Hughes, Roger, and n/a. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia." Griffith University. School of Health Science, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040615.120233.
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Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.
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Hughes, Roger. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia." Thesis, Griffith University, 2004. http://hdl.handle.net/10072/366114.
Full textAbstract:
Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Sciences
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Cargill, Barbara J., and n/a. "Models of organizational and managerial capability for the entrepreneurial university in Australia." Swinburne University of Technology, 2007. http://adt.lib.swin.edu.au./public/adt-VSWT20070423.094131.
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Prompted by the observation that some Australian universities state that they wish to be entrepreneurial, and appear to be only mildly successful at it, whilst others are entrepreneurial by any measure and yet do not state that aim, this study explores what it means to be an entrepreneurial university in the complex and challenging Australian context. It asks the key question �What does it take?� in seeking to identify the organisational and managerial capabilities that underpin successful entrepreneurial outcomes with a view to developing a model that can assist senior university executives in their managerial and leadership practice.
The study is undertaken in an interpretive, qualitative research framework where an initial model based on a literature synthesis, using the work of Clark as a starting point, is presented to a group of participants. All are either present or recent vice-chancellors, higher education industry experts and bureaucrats, or are senior technology transfer managers concerned with direct entrepreneurial efforts in larger universities. In two iterations, the participants are engaged in dialogue about the model, refining and commenting on it until their views are incorporated and it more closely approximates their own mental models for the practice of entrepreneurship in the university.
Their comments about related issues of government policy, current national and international trends, their respective university strategies and concerns are also incorporated to add rich meaning to their views on the model itself.
The study concludes that there are five clusters of capabilities involved in building an entrepreneurial university in the Australian setting. They are labelled Context, Strategy, People, Enabling Mechanisms and Culture and Internal Politics in this study. There is some overlap with those elements Clark originally identified but also some notable additional emphasis and detail added. In this study, the capability clusters related to relationship with environment and Context and that relating to Strategy and strategic leadership in general are found to be more important than Clark indicated, more crucial in the present Australian context and generally more underdeveloped in Australia than the current circumstances would indicate is necessary.
It is concluded that where entrepreneurship is handled as a marginal, optional, or half-hearted pursuit, and the concept not fully embraced, it is likely to result in haphazard outcomes, not always enhancing or progressing the institution in its desired direction. In contrast, successful entrepreneurship in and by Australian universities essentially requires greater emphasis on the capabilities of strategic management and plans that place entrepreneurship centrally in an integrated strategic entrepreneurship framework.
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Garske, Gary L. "Continuity planning for local public health agencies in northern Wisconsin : providing essential public health services after displacement /." Connect to online version, 2009. http://digital.library.wisc.edu/1793/37472.
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Nagashima, Takeshi. "Arthur Newsholme and English public health administration 1888-1919." Thesis, University of Sussex, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366211.
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England came to have a nation-wide administrative system for public health in the 1870s. It consisted of the local councils which were designated as sanitary authorities and the Local Government Board (LGB) as the central department. This thesis explores how public health reform was pursued under this administrative system, by tracing the career of Arthur Newsholme (1857-1943), who served as Medical Officer of Health (MOH) for Brighton, 1888-1908, and as Medical Officer to the LGB, 1908-19. The main aim of the thesis is to examine the activities in which Newsholme was involved and his views, in order to consider the development of public health activities, or state medicine, in relation to the traditional notions of government and society in England, that underlay the administrative system such as 'minimal government', , local self-government' or 'voluntarism'. The first half of the thesis deals with public health reform in Brighton during Newsholme's years of office as local MOH. Particular attention is paid to how the scope of public health administration was decided through interactions between the MOH and the local council as a representative body of the community, and to how voluntary efforts were involved in its extension. The second half deals with Newsholme's administrative ideas and activities in the process of, and after, becoming the country's leading health official. By the time of his assumption of office at the LGB, Newsholme envisaged a comprehensive state medical service as the ultimate medical ideal. The thesis examines how he tried to pursue this ideal by means of reconciling it with traditional ideas of government. Special attention is paid to Newsholme's difference from his fellow reformers such as the Webbs and George Newman, particularly in respect of their recognition of the framework of centralllocal relations that underlay the administrative system, and concerning how reforms should or could be proceeded with by means of central bureaucratic initiatives.
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McGuiness, Clare Frances. "Client perceptions : a useful measure of coordination of health care." View thesis entry in Australian Digital Theses Program, 2001. http://thesis.anu.edu.au/public/adt-ANU20020124.141250/index.html.
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Ramanathan, Vijayasarathi, Virginia Furner, Sarangapany Jeganathan, Katerina Lagios, Melissa Kang, and Eva Jackson. "Accessibility and Acceptability of Public Sexual Health Clinics for Adult Clients in New South Wales, Australia." Thesis, Masters in Medicine (STD/HIV) The University of Sydney, 2006. http://hdl.handle.net/2123/3573.
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The objectives of this study were to examine the accessibility of public sexual health clinics (SHCs), identify the service preferences of clients and assess whether the services delivered by public SHCs were acceptable (suitable) to users’ expectations. Participants were adult clients attending public SHCs in 4 different geographical regions of New South Wales (NSW). A self completed anonymous questionnaire survey was employed in this study and the data was collected over a two week period per clinic. The overall participation rate was 89%. Three hundred and two clients participated of which 68.2% and 31.8% were males and females respectively. Geographical proximity to residence or work was the single most common reason cited to choose a particular clinic by all clients. The main source of information about public SHCs for young and middle aged clients was their personal contacts, whereas for older individuals it was health professional’s referral. Of the total sample, nearly 59% vs. 32% of clients used private and public transport to get to the clinic. About 80% of private transport users of the city and suburban clinics had indicated some difficulty with parking facilities. For more than two thirds of clients, the time taken to get to the clinic was less than 30 minutes. Overall, more clients preferred an appointment (56%) compared to a walk-in (32%) system. Nearly 65% of all clients preferred to attend the clinic during the weekdays and about 11% preferred weekends. Of those clients who had a preference for a time to attend a clinic, 83.3% attended clinic in their preferred time. Overall, more than one third (39%) of all clients preferred a same gender health care worker (HCW) whereas 13% of clients did not prefer a same gender HCW. Among clients who had a clear preference, more than 90% of all females and nearly 80% of overseas born males preferred a same gender HCW. More females (81%) than males (59%) were actually able to have a consultation with a HCW of their preferred gender. The majority (79%) of clients preferred to consult the same doctor in the follow up visits and only a few clients (5%) preferred a separate male and female waiting room. The vast majority (97%) of clients had no difficulty with language during consultation. About 93% of clients had rated the services delivered by public SHCs to be either excellent or good. The public SHCs were found to be accessible and acceptable to the clients who currently utilise them. Designated parking spaces for the city and suburban clinic users and providing an option for female and overseas born male clients to select a HCW of their preferred gender need to be considered. Further research is required to examine accessibility and acceptability aspects of public SHCs for the potential clients who either currently use other services or do not access any form of services.
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Britton, Michael J. "The quest for a formula : parliamentary remuneration in Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2005. https://ro.ecu.edu.au/theses/397.
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The Western Australian Payment of Members Act 1900 was promulgated upon two tenets, namely, that Members of Parliament should be compensated for their services to society and that other Australian colonies were already receiving some form of compensation. The premise stipulated that all people, regardless of economic background should be given an opportunity to fulfil the honourable duly of a Representative. Remuneration in this thesis covers the minimalist advent of Parliamentary Remuneration whereby Mrs were compensated by way of a basic salary to the current multifaceted Parliamentary Remuneration which encompasses various structures, processes and is often overarched by complicated determinative methodologies. Remuneration was the original term given for the payment of services rendered. The contemporary understanding of Remuneration extends to salary, superannuation ;Ind an additional raft of entitlements. Since the form of Parliamentary Remuneration has evolved, so too has public disputation grown over the various entitlements that MPs receive. Parliamentary Remuneration has become a highly contentious issue. However, despite the nature of the topic there is a surprising absence of research on the topic. This study is the only known historical and analytical account of Parliamentary Remuneration that has been written apart from reports prepared by Governmental agencies or Parliamentary Remuneration tribunals. The Quest for a Formula will review the historical remunerative determinations that have occurred within Western Australia since the tum of the 20th Century, contrasting the findings of this study against historical experiences that can be drawn from other democratic-Commonwealth countries such as Britain and Canada. For comparison the thesis will also investigate how various enterprises, both public and private, remunerate their employees in accordance to various performance management indicators. This study suggests that the methods that have been at use within Western Australia, and various other Commonwealth-based jurisdictions, may require an overhaul. However, given the unique nature of parliamentary duties, attempts to provide a set of performance criteria have proved difficult to establish. Nonetheless this thesis proposes a systematic determinative process that is more transparent than current procedures. The thesis has found the determinative process in Western Australia to be redundant as it appears to be overlapped by the Federal Remuneration Tribunal. Many types of determinative processes have been employed by various Governments; this study illustrates the equitable methodologies compared to inequitable methods. This thesis also proposes that the general standing of an MP within Australian society may be raised through the development of a more transparent system of determination that encourages public input. Aside from this, a remunerative determination should take into consideration an MP's experience along with the size, demographics .)f their electorate. Parliament should also frequently employ private management consultants that can individually assess each MP's workload, consequently producing an impartial recommendation on the state of MP remuneration. This thesis proposes that the employment of such consultants may allow for MPs to communicate numerous ways that they could be more efficient and could also generate 'work plans' to assist them in achieving their everyday goals. This study will also find that, while a new more transparent system of determination is required within both Western Australia and Australia, the possibility of implementing a performance management system to consequently remunerate MP is highly unlikely, Finally, a recommendation of this thesis will propose new structures, processes and mathematical formulae in determining an MP's overall worth.
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Rakate, Nyana Faith. "Transformation in the South African public service the case of service delivery in the department of health /." Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-02132007-185213/.
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Bosworth, Ryan Cole. "Demand for public health policies /." view abstract or download file of text, 2006. http://proquest.umi.com/pqdweb?index=0&did=1192186841&SrchMode=1&sid=1&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1176749188&clientId=11238.
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Thesis (Ph. D.)--University of Oregon, 2006.Typescript. Includes vita and abstract. Includes bibliographical references (leaves 127-130). Also available for download via the World Wide Web; free to University of Oregon users.
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Robins, Greg. "Is a knowledge based value network an effective model for implementing e-government?" Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2004. https://ro.ecu.edu.au/theses/832.
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Is a knowledge based value network an effective model for implementing e-government? E-Government is a vision of how public sector organisations will govern, serve citizens, and interact with business partners, their employees, and other Government organisations. The “e” in e-Government represents a move to fully integrated, secure, on-demand accessible electronic Government that will: • improve integrated service delivery • provide universal citizen access • begin to enhance traditional Government structures and processes • support new Government products and services by relying on the emergence and convergence of new technologies • improve effectiveness Electronic commerce (e-commerce) has fundamentally changed the way business is being conducted and Government is rushing to catch up.
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Cullerton, Katherine B. "An exploration of the factors influencing public health nutrition policymaking in Australia." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/109095/1/Katherine_Cullerton_Thesis.pdf.
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This thesis was an exploration of the factors that influence nutrition policymaking in Australia which resulted in strategies that could be used by poorly-resourced health organisations to gain traction in public health nutrition policymaking. Insight into these strategies was gained through a social network analysis exploring the power of interest groups and their influence on nutrition policy in Australia and in-depth interviews with these key influencers.
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Watts, Christina. "Tobacco industry interference in supply-side policies in Australia." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/24682.
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Tobacco smoking rates in Australia are at a historic low, largely due to decades of tobacco control policy reforms aimed at reducing consumer demand for tobacco products. However, while some conditions have been placed on the sale of tobacco, such measures are not explicitly aimed at reducing the supply of tobacco products by restricting their sale. Tobacco therefore remains one of the most widely available consumer goods on the market in Australia, which contributes to a perception that tobacco is a normal part of everyday life. The widespread retail availability of tobacco in Australia undermines smokers quit attempts and increase impulse purchases, which ultimately increases tobacco consumption.
Regulating the supply of tobacco in Australia is an essential next step to achieving future reductions in smoking prevalence. However at present, the lack of regulation on the “supply-side” of tobacco control presents opportunities for the tobacco industry to exploit loopholes, undermine tobacco control policies and exert its power and influence. Tobacco companies and tobacco retailers both play a unique and interrelated role in the sale of tobacco in Australia and it is critical that research exploring supply-side tobacco control policies investigates the motivations and activities of both tobacco companies and retailers, and how they work together. This is particularly paramount in light of the tobacco industry’s increasing attempts to reframe its corporate image alongside efforts to undermine and influence the public health policy landscape.
This body of work will establish an understanding of attitudes, beliefs and experiences of retailers in regards to selling tobacco and uncover the ways in which tobacco companies manage relationships with retailers to covertly market their products to maximise profitability. It will also investigate the tobacco industry’s tactics to interfere with and influence policy through a corporate social responsibility agenda and explore the implications of this on tobacco retail reform in the future.
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White, Jasmin. "Oral health problems of elderly women in Australia : an holistic approach." Thesis, The University of Sydney, 1996. http://hdl.handle.net/2123/4630.
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Pitman, Grant Alan, and n/a. "Police Minister and Commissioner Relationships." Griffith University. School of Public Policy, 1998. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030228.140953.
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Australian Police Ministers and Commissioners occupy a pivotal position in the system of law enforcement. Collectively, they are responsible for the general policy, administration and operational direction and control of policing through the Australian States. There has been in the past twenty five years a growing complexity and a variety of problems facing police agencies which are arduous and demanding. Continuing social tension of recent years have given police ministers and commissioners higher public profiles than ever before. The research undertaken in this thesis examines the difficulties experienced between police ministers and commissioners in Queensland and New South Wales from 1970 to 1995. Three models have been developed as a framework to analyse the relationships and how they operate. The three models are called - 'Dependency', 'Independency' and 'Interdependency'. Twenty-one police ministers, commissioners and advisers from Queensland and New South Wales were interviewed during the course of the research. Five separate case studies were developed to analyse and interpret the relationships within the context of the three models. A summary chapter of additional research data provides supporting information which was used to substantiate the case study material. The conclusion argues that relationships operate more effectively when elements of the 'Interdependency' model exist. The need for further debate about the administrative, legal and management elements of the working relationship between a police minister and commissioner is essential to achieve a balance between policy, administration and operational requirements within a modern western democratic policing system.
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Osborne, Alexandria K. "Managing health care in a Libyan public hospital: A case study." ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/730.
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Libyan citizens who can afford private health care are opting out of the public health care system. They have a perception that the quality of public health care has deteriorated. The negative perceptions have resulted in a lack of trust by many of Libyan's citizens in the Libyan public health care system and consequently to unequal access to quality health care. The purpose of this study was to identify the factors that have led to the negative perceptions and mistrust. The conceptual support for the study was based on a construct of trust that defines trust as the state of readiness for unguarded interaction with someone or something. Key research questions examined the role Libyan cultural values and privatization of healthcare might have played in creating the negative perceptions and mistrust of the healthcare and its delivery and whether the perceptions and mistrust varied between the patients and healthcare providers. The research methodology used for this study was a qualitative exploratory single-case study. Fifty participants were interviewed during a one-month period. Responses were coded using ATLAS.ti. Study results provided an understanding of the cultural considerations, the impact of privatization, and the respondents' perceptions of Libyan public health care. Results indicated that respondents demonstrated the capacity to trust but did not consistently have positive perceptions of competence and intention of administrators of the public health care system. The findings suggest that patients view the behavior of providers as an indication of their level of skill. Additionally, respondents perceived that they will have a higher level of service if they have a personal recommendation. The social change implication for this study is that overcoming these negative perceptions and improving trust can lead to equal access to quality health care.
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Sadleir, Christopher. "On the Frontier : Australia's policy approach to foreign direct investment 1968 - 2004 as a case study in globalisation, national public policy and public administration /." full text via ADT database, 2007. http://erl.canberra.edu.au/public/adt-AUC20080304.145454/index.html.
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Madzokere, Eugene T. "The Current Status, Evolution and Spread of Arboviruses Circulating in Australia." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/417227.
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Arboviruses circulating in Australia are of clinical importance as they cause painful, often chronic musculoskeletal arthritic or fatal dengue disease. They include Ross River virus (RRV), Barmah Forest virus (BFV), chikungunya virus (CHIKV) and dengue virus (DENV). This dissertation assessed the seroprevalence, diversity, evolution, spread and strategies for controlling infection caused by these arboviruses. The overall aim of research presented in this dissertation was to improve public health responses such as nationwide surveillance, diagnosis, and infection control.
Research undertaken in chapter 2 achieved this through systematic review and statistical synthesis of human seroprevalence data for RRV, BFV and DENV. I have shown that many factors influence the reporting of human seroprevalences for these three arboviruses. Among these factors is the choice of assay method, timeframe, and sampling strategy. I have also presented findings showing that the spatiotemporal range and median seroprevalences reported for DENV and RRV are wider and higher than those for BFV. This indicates that the risk of exposure to DENV and RRV is significantly higher and extends overseas, however this risk relates to the distribution of the transmitting vectors. My analysis highlighted that DENV presents the highest risk of exposure but its incidence in Australia is declining due to successful implementation of Wolbachia-DENV control programs which have restricted the distribution of Aedes aegypti. Most serosurveys reviewed reported a positive association between age and seroprevalence, and increasing seroprevalence with gender. However, studies reporting gender-seroprevalence data did not do statistical analysis to show the significance of outcomes. This dissertation therefore recommends streamlining, standardization and statistical synthesis of serosurveys data to better quantify risk of exposure, identify risk factors, at-risk groups/populations, associations between seroprevalence and risk factors and at-risk groups/populations.
In chapter 3, I characterised the phylogenetic relationship among 193 RRV near whole genomes sourced from multiple hosts, nationwide and the Pacific, in-between 1959-2018. Eight-six of these genomes were generated in this dissertation. My assessment revealed that the four RRV genotypes display high levels of intra-genomic diversity, as I was able to characterise the virus into eight additional sublineages within genotypes G1 (n = 2), G3 (n = 5) and G4 (n = 1). This characterisation brings the total number of known RRV sublineages to 13. Only three of these sublineages (G3D, G4A and G4B) contain viruses that have circulated in Australia within the last decade. The last sampling of genotype 1 and 2 (G1 and G2) viruses was in 1976 and 1995 from Queensland and Western Australia. These viruses may no longer be in circulation within Australia. Sublineages G4A and G4B the most dominant circulating variants of RRV in recent times but they are spatially restricted to Eastern and Western Australia. My phylogenetic analysis suggests that a human traveller likely introduced RRV into the PICTs from northern rather than eastern Australia causing the explosive 1979-80 epidemic. This hypothesis builds upon the one postulated by authors of previous studies who used genomic datasets for RRV isolates sampled from a few locations and not nationwide as I did. Future studies are required to determine differences between RRV sublineages, factors driving lineage replacement, and understand the role of positively selected codon site to RRV evolution.
For chapter 4, I studied the evolution, dissemination and phylogenetic relation between 87 BFV near whole genomes sourced nationwide and from Papua New Guinea from three hosts; humans, mosquitoes and a macropod, during 1974-2018. Fifty-four of these genomes were generated in this dissertation and were sampled throughout Australia. Despite the addition of these new genomes to the BFV phylogeny, results obtained indicate that BFV still consists of three genotypes with most new genomes generated from isolates sampled from northern, eastern, and Western Australia grouping in genotype G3. This dissertation reconstructed the most plausible and statistically supported dissemination pathways for BFV and identified the PNG as the most likely source of the virus. The impacts of nucleotide variation within repeat sequence elements and positive selection with the nsP1 Mtase-Gtase domain on virus replication and host range need to be investigated further.
For Chapter 4 and 5, I showed that BFV and RRV have a synonymous codon usage bias toward A or C at the 3rd codon position; an abundance of CA and UG, and suppression of CG and UA dinucleotides; display coincidental and antagonistic synonymous codon usage bias with their respective mosquito and vertebrate hosts. In chapter 7, I also showed that amino acid coevolution and compositional biases are prevalent within protein coding regions belonging to RRV and BFV. I found translational selection to be the most influential evolutionary force driving RRV codon usage patterns (chapter 5). Mutational pressure was a close second. I also identified host motifs associated with RRV and BFV coevolving sites. Altogether these results indicate that many factors drive RRV and BFV evolution, among them virus and host related influences. Investigation of the clinical relevance of these findings (chapters 4, 5, and 7) is required.
In chapters 6 of this dissertation, I identified five drugs [Anidulafungin (an antifungal), Fondaparinux (an anticoagulant), Rifabutin (an antibiotic), Deslanoside (a cardiac glycoside), and Temsirolimus (an antineoplastic agent)] that bind with high affinity, potency and efficiency to the RRV, BFV and CHIKV capsid. Their role as capsid inhibitors and potential treatments for RRV, BFV and CHIKV infection needs validating through functional and preclinical studies. In chapter 8, I proposed a strategy for generating integrated species distribution modelling frameworks to improve prediction of mosquito-vector habitat shifts in the future. Such modelling frameworks do not currently exist and so their generation and evaluation as an additional component to existing vector and arbovirus surveillance initiatives in Australia is required.
This dissertation has addressed its research aims and hypothesis. It has demonstrated that robust nationwide surveillance, review and synthesis of seroprevalence, genomic, host, and environmental data for RRV, BFV and DENV enhances the understanding and management of arbovirus epidemics, virus characterisation and discovery, and infection control in Australia. This research has also shown that some of the factors driving alphavirus evolution, can be exploited for vaccine development. In addition, this dissertation has also presented five approved medicines with potential for repurposing as anti-alphaviral treatments. More broadly, this dissertation has generated new strategies and concepts for improving arbovirus surveillance and infection control in Australia.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Institute for Glycomics
Griffith Health
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Stewart, Anthony Paul. "[Epidemiology : reports and papers]." Master's thesis, Canberra, ACT : The Australian National University, 1993. http://hdl.handle.net/1885/142697.
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McGuire, Linda. "Counting quality or qualities that count? : an inquiry into performance reporting for professional public services in Australia." Monash University, Dept. of Management, 2004. http://arrow.monash.edu.au/hdl/1959.1/5247.
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Martin, Marie H. "An Empirical Investigation of Funding Trends and Organizational Composition in Global Health." Thesis, Tennessee State University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10119094.
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Over the past two decades, development assistance for health and government health expenditure have both increased substantially. Despite the rise in public attention and funding levels internationally, there has been little empirical exploration of budgetary trends in global health funding. Through the use of public budgeting and finance theories, these three studies in aim to increase understanding of the flow of health funds between and within donor and recipient countries through time. Application of Punctuated Equilibrium Theory (PET) to multiple datasets of national health financing data illustrates a leptokurtic distribution for both own domestic health (government health expenditure) and other health (development assistance for health) spending. The distribution of change in government health expenditure by 15 OECD donor countries was found to be less punctuated that their development assistance for health to developing countries from 1990-2012, suggesting smoother, more constant pressures for “own health” spending versus spending for global health. Comparison of country-level annual changes in government spending on domestic health for 145 countries between 1995 and 2012 illustrated that overall, and when grouped by income, the distributions of countries’ pooled annual changes in government health spending were leptokurtic. There was a greater departure from the normal distribution as country income decreased across the highest and two lowest income groups, and the proportion of annual changes that were positive decreased. However, the high-income non-OECD and upper-middle income groups diverged from this trend in interesting ways. Empirical exploration of the changing organizational composition of the field through the lens of population ecology provides greater context for the funding trends in global health with a particular focus on the emergence of public private partnerships. Application of the Herfindahl-Hirschman Index (HHI) found a decrease in concentration in the organizational field of global health between 1990 and 2000, followed by stability in the field despite the introduction of a new organizational form. Over this period, there were increases in ‘market’ shares for non-profit organizations and PPPs within the global health organizational population. The grant making-behavior directed through PPPs by a significant US bilateral agency was explored to identify patterns in decision-making related to PPP lifespan, disease focus, program type, regional focus, implementing partner categories and financial commitment, as well as recession impact. The limited empirical research concerning actors in global health funding emphasizes the need for further exploration of this phenomenon.
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Stanton, Deborah Jane. "Taking shape implementing citizen-centric local digital government in Western Australia /." Connect to thesis, 2007. http://portal.ecu.edu.au/adt-public/adt-ECU2008.0011.html.
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Norrie, Philip Anthony. "Wine and health through the ages with special reference to Australia /." View thesis, 2005. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20060420.102152/index.html.
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Thesis (PhD.)-- University of Western Sydney, School of Social Ecology and Lifelong Learning, 2005."A thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy, School of Social Ecology and Lifelong Learning, University of Western Sydney." Includes bibliographical references and index.
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Knutson, Donna Beth. "Drills and Exercises as Interventions to Improve Public Health Emergency Response." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1063.
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The 2001 destruction of the World Trade Center and the subsequent anthrax attacks highlighted the inability of an antiquated public health system in the United States to respond effectively to emergencies. Little documentation exists to define how public health agencies can improve performance. The overarching research question was the extent to which drills and exercises improve performance in public health emergencies. Adult learning theory and deliberate practice theory were explored in this context. The research data were from 50 state public health departments, which were required to report performance information to the U.S. Centers for Disease Control and Prevention. The data were examined using Poisson analysis and logistic regression. Results indicated that drills and exercises had no statistically significant impact on public health performance for the 3 performance measures examined; of all predictors, what explained the most variance in reaching performance targets was the number of real emergencies to which a health department had responded in the past. Performing drills and exercises did not predict the likelihood of reaching performance targets. These findings have implications for positive social change for Congressional leaders and other government representatives. Such public servants could use this information to guide their efforts to redirect public health emergency preparedness funds away from drills and exercises and toward other fundamental public health activities. These more focused efforts could facilitate the improvement of public health laboratory capacity, the training of field epidemiologists, and the advancements in technology for enhanced reporting and surveillance.
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Walker, Agnes Emilia, and Agnes Walker@anu edu au. "Modelling the links between socioeconomic status and health in Australia: a dynamic microsimulation approach." The Australian National University. National Centre for Epidemiology and Population Health, 2005. http://thesis.anu.edu.au./public/adt-ANU20060127.120857.
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This thesis concerns the modelling of individuals health over the life course, within the framework set by the now substantial international literature on the relationship between socioeconomic status and health. The focus is on people with long term illnesses and related disabilities, on inequalities in health by socioeconomic status (SES) and on the impact of health on employment.¶
The main tool of analysis is a dynamic microsimulation model of the Australian population which tracks the demographic, socioeconomic and financial characteristics of individuals and their families over the life course. Its original form, developed at the National Centre for Socioeconomic Modelling, University of Canberra, is based on a one per cent representative sample of the Australian population (around 150,000 individuals), with a series of life course events simulated for individuals and their families up to 2050 - such as births, deaths, migration, taxes, education, labour force participation, earned income, wealth accumulation and government transfers. The model is written in the C programming language and was initially used on a UNIX system. The dramatic increases in the speed and memory size of PCs over the past five years has led to a PC version now being available.¶
Despite their relatively short existence and long development phases, dynamic microsimulation models are now used in many developed countries for example, the USA, UK, Canada, France, Sweden, Norway and Italy. In recognition of their ability to analyse distributional and financial issues in considerably greater depth than what is possible with traditional methods, their use by government for policy analysis is rapidly increasing.¶
In this thesis two new modules were added to the original Australian dynamic microsimulation model namely: a Health_SES module and a Health State Transitions module. The former makes the study of health inequalities across socioeconomic groups possible. The latter provides a link between health status and the ability of individuals to carry out every day activities as the severity of their ill-health increases with age. A major advantage of adding these new modules to an existing main model is that it allows much more comprehensive studies over the life courses of individuals than the alternative would allow that is the building of two stand-alone models developed exclusively for health-SES and health state transition types of applications.¶
The main data sources used to construct the two new modules were an extract from the Australian Institute of Health and Welfares Mortality database covering the 1995-97 period, and the Australian Bureau of Statistics 1998 survey of Disability, Ageing and Carers. The analysis of the mortality data was handled using EXCEL, and that of the much larger Disability survey unit record dataset - over 40,000 individuals and 100s of variables using the SAS programming language.¶
While most of the methodologies used in constructing the new modules are in line with what became the norm for dynamic microsimulation model development, the thesis contains several innovations. The main ones are: a quantitative assessment of the suitability of different types of SES indicators for studies of health inequalities; the modelling of the progression of peoples health from illness-free status to mild and severe disability; the development of a methodology for estimating health state transition probabilities from cross-sectional data (in the absence of longitudinal data); and the linking of health status to individuals ability to stay in the labour force.¶
As with most models, there are a number of limitations. These are discussed in the thesis, together with areas of possible future improvements.¶
The thesis also presents two novel and topical though at this stage illustrative applications of the enhanced dynamic microsimulation model. The first simulates the impact of a narrowing in health inequalities in Australia as health is lifted nationally to the level currently enjoyed by the most affluent 20% of the population. The findings are that, if such a policy change were implemented, close to half a million fewer Australians would be disabled, around 180,000 life years would be saved, health care costs would be around A$1 billion lower per year and the government could save close to A$700 million on the Disability Support Pension.¶
The second application quantifies the likely impacts of longer working lives in future, which may arise from changes such as: more favourable labour market conditions; government incentives to remain in the labour force longer (eg the lifting of the pension age); and general improvements in health. This application estimates the probability that Australians aged 65-70 would work more than 15 hours per week, had such changes eventuated. The decision to retire is modelled as a function of each individuals own health, socioeconomic status, age, sex and family composition. The impacts are simulated in a world in which current patterns of health by age, sex and SES remain unchanged over time the Base case; and a world replicating the narrower health inequalities scenario of the first application. Under the Base case an additional 450,000 persons aged 65-70 years were estimated to remain in the workforce - with the related earnings totalling up to $20 billion in 1998 ($35 billion in 2018) and savings by government on the age pension of around $2 billion ($4 billion in 2018). Under the narrower health inequalities scenario the numbers working, their earnings and the related savings on the age pension were estimated to be around 7% higher.
Much of the original research carried out for this thesis has appeared, or is yet to appear, in refereed publications.¶
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Haysom, Georgina. "Legislating science and morality : statutory schemes for the regulation of reproductive technology in Australia, Canada and the United Kingdom." Thesis, McGill University, 1997. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=27453.
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Reproductive and genetic technologies ("RGTs") raise many complex social, legal and ethical issues. Several jurisdictions have perceived a need for government intervention and regulation of the conduct of RGTs, and consequently have enacted legislation to this end. In three states in Australia (Western Australia, Victoria and South Australia) and in the United Kingdom, legislation has been introduced which imposes a regulatory scheme according to which RGTs must be practised in each jurisdiction. Legislation based on the recommendations of the Royal Commission on New Reproductive Technologies is currently before the Canadian parliament.This thesis examines from a comparative perspective the proposed legislation in Canada and legislation enacted in the United Kingdom and the Australian states to govern the conduct of RGTs. Particular emphasis is given to the manner in which the legislation seeks to deal with the rapid pace of scientific development and with moral pluralism. The focus of the thesis is on the effectiveness of the legislation in these jurisdictions in light of the relationships between law and science and law and morality.
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Joiner, Amber J. "Implementing the Affordable Care Act's Health Insurance Marketplaces| An Analysis of Enrollment Success by Marketplace Type." Thesis, University of Nevada, Reno, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13425412.
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On October 1, 2013, the most visible component of the Patient Protection and Affordable Care Act (Public Law 111-148) (ACA) went live. Health insurance marketplaces provided residents with a place to shop and receive subsidies for insurance plans that contained the essential health benefits required by the ACA. The ACA required each state to establish an exchange, but it also provided flexibility so if a state elected not to (or could not) build its own, the federal government would implement the marketplace. A handful of states chose a hybrid implementation, which used the federal HealthCare.gov website but left certain decisions to the states. In the end, twice as many states chose to use the federal HealthCare.gov website compared to states that created a state-based marketplace and website. This trifurcated approach to implementing the health insurance marketplaces where residents were either served by a federally-facilitated, state-based, or hybrid marketplace, provides a unique situation for comparison and analysis relating to federalism and public policy implementation.
This policy analysis examines the implementation of the ACA’s health insurance marketplaces in all 50 states and the District of Columbia. It discusses enrollment success during the first five open enrollment periods across all three marketplace types.
Among the federally-facilitated, state-based, or hybrid marketplaces, was one type more successful than the others at enrolling residents in health insurance? What factors may have played a role in success or failure? This study discusses the ACA marketplaces as a case study in federalism and public policy implementation.
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Chalmers, Jane. "The oral health of older adults with dementia." Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phc438.pdf.
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Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.
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Duldig, Paul. "The extent of private health insurance coverage in Australia : public problem or private choice? /." Title page, contents and introduction only, 1985. http://web4.library.adelaide.edu.au/theses/09EC/09ecd881.pdf.
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